Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer
Purpose In stage II colorectal cancer (CRC), high-risk patient selection is required, but no candidate markers have been elucidated. Our concern was whether anastomotic leakage (Lk) is a potential available clinicopathological factor for selecting high-risk stage II. Methods Two hundred seven patien...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2011, Vol.15 (1), p.120-129 |
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| creator | Katoh, Hiroshi Yamashita, Keishi Wang, Guoqin Sato, Takeo Nakamura, Takatoshi Watanabe, Masahiko |
| description | Purpose
In stage II colorectal cancer (CRC), high-risk patient selection is required, but no candidate markers have been elucidated. Our concern was whether anastomotic leakage (Lk) is a potential available clinicopathological factor for selecting high-risk stage II.
Methods
Two hundred seven patients with stage II CRC who underwent curative resection were analyzed. Clinical variables were tested for their relationship to survival.
Results
The 5-year disease-free survival rate (DFS) was 87.0%. The univariable prognostic analyses indicated that Lk (
P
= 0.003) was the only significant factor. The multivariable prognostic analysis revealed that Lk remained to be potently independent [hazard ratio (HR), 4.21,
P
= 0.021), and the DFS was 58.3% in cases with Lk, while 88.7% in the counterpart. The multivariable logistic regression analysis revealed perioperative blood transfusion (
P
= 0.001) was independently associated with Lk. Intriguingly, Lk was closely associated with hematogenic recurrence (
P
= 0.003) rather than peritoneal or local recurrence. Although sustained increase of the serum C-reactive protein at 2 weeks after operation predicted poor prognosis, the mutitivariable analysis including the C-reactive protein level revealed that Lk still indicated the prognostic potential (HR, 3.70,
P
= 0.075).
Conclusions
The findings concluded that Lk may be a high risk for systemic recurrence in stage II CRC. |
| doi_str_mv | 10.1007/s11605-010-1379-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_845765015</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4321965689</sourcerecordid><originalsourceid>FETCH-LOGICAL-c437t-90b7aa20fc7ba351c7bb7c5a85aaf87374fa408b4bd9f076d108c5c9b72979203</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMofv8ALxLw4Kk60yZNepTFj4UFwVXwFtJsulbbRpP0sP_eLKsigqeZYZ73TeYl5AThAgHEZUAsgWeAkGEhqoxtkX2UoshYmZfbqYcKs5zz5z1yEMIrAApAuUv2cgSZlHKf6KtBh-h6F1tDZ1a_6aWlEzdE39ZjtIFGR-OLpQ9teKON83S-CtH2CX6wZvTeDsbSdqDzuBZOp0nbOW9N1B2d6LT0R2Sn0V2wx1_1kDzdXD9O7rLZ_e10cjXLDCtEzCqohdY5NEbUuuCYSi0M15Jr3aSbBGs0A1mzelE1IMpFOsFwU9Uir0SVQ3FIzje-7959jDZE1bfB2K7Tg3VjUJJxUXJAnsizP-SrG_2QPqdQVsiASZknCjeU8S4Ebxv17tte-5VCUOv41SZ-Bes5xa9Y0px-OY91bxc_iu-8E5BvgJBWw9L6X0__6_oJlLOPJw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1891404882</pqid></control><display><type>article</type><title>Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Katoh, Hiroshi ; Yamashita, Keishi ; Wang, Guoqin ; Sato, Takeo ; Nakamura, Takatoshi ; Watanabe, Masahiko</creator><creatorcontrib>Katoh, Hiroshi ; Yamashita, Keishi ; Wang, Guoqin ; Sato, Takeo ; Nakamura, Takatoshi ; Watanabe, Masahiko</creatorcontrib><description>Purpose
In stage II colorectal cancer (CRC), high-risk patient selection is required, but no candidate markers have been elucidated. Our concern was whether anastomotic leakage (Lk) is a potential available clinicopathological factor for selecting high-risk stage II.
Methods
Two hundred seven patients with stage II CRC who underwent curative resection were analyzed. Clinical variables were tested for their relationship to survival.
Results
The 5-year disease-free survival rate (DFS) was 87.0%. The univariable prognostic analyses indicated that Lk (
P
= 0.003) was the only significant factor. The multivariable prognostic analysis revealed that Lk remained to be potently independent [hazard ratio (HR), 4.21,
P
= 0.021), and the DFS was 58.3% in cases with Lk, while 88.7% in the counterpart. The multivariable logistic regression analysis revealed perioperative blood transfusion (
P
= 0.001) was independently associated with Lk. Intriguingly, Lk was closely associated with hematogenic recurrence (
P
= 0.003) rather than peritoneal or local recurrence. Although sustained increase of the serum C-reactive protein at 2 weeks after operation predicted poor prognosis, the mutitivariable analysis including the C-reactive protein level revealed that Lk still indicated the prognostic potential (HR, 3.70,
P
= 0.075).
Conclusions
The findings concluded that Lk may be a high risk for systemic recurrence in stage II CRC.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-010-1379-4</identifier><identifier>PMID: 21086058</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdomen ; Anastomotic Leak - epidemiology ; Blood transfusions ; Cancer therapies ; Chemotherapy ; Colonoscopy ; Colorectal cancer ; Colorectal Neoplasms - epidemiology ; Colorectal Neoplasms - surgery ; Disease ; Disease-Free Survival ; Emergency medical care ; Female ; Follow-Up Studies ; Gastroenterology ; Humans ; Incidence ; Japan - epidemiology ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Staging ; Original Article ; Patients ; Prognosis ; Proteins ; Retrospective Studies ; Risk Factors ; Surgery ; Surgical anastomosis ; Survival Rate - trends ; Time Factors</subject><ispartof>Journal of gastrointestinal surgery, 2011, Vol.15 (1), p.120-129</ispartof><rights>The Society for Surgery of the Alimentary Tract 2010</rights><rights>Journal of Gastrointestinal Surgery is a copyright of Springer, 2011.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-90b7aa20fc7ba351c7bb7c5a85aaf87374fa408b4bd9f076d108c5c9b72979203</citedby><cites>FETCH-LOGICAL-c437t-90b7aa20fc7ba351c7bb7c5a85aaf87374fa408b4bd9f076d108c5c9b72979203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-010-1379-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-010-1379-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21086058$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Katoh, Hiroshi</creatorcontrib><creatorcontrib>Yamashita, Keishi</creatorcontrib><creatorcontrib>Wang, Guoqin</creatorcontrib><creatorcontrib>Sato, Takeo</creatorcontrib><creatorcontrib>Nakamura, Takatoshi</creatorcontrib><creatorcontrib>Watanabe, Masahiko</creatorcontrib><title>Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Purpose
In stage II colorectal cancer (CRC), high-risk patient selection is required, but no candidate markers have been elucidated. Our concern was whether anastomotic leakage (Lk) is a potential available clinicopathological factor for selecting high-risk stage II.
Methods
Two hundred seven patients with stage II CRC who underwent curative resection were analyzed. Clinical variables were tested for their relationship to survival.
Results
The 5-year disease-free survival rate (DFS) was 87.0%. The univariable prognostic analyses indicated that Lk (
P
= 0.003) was the only significant factor. The multivariable prognostic analysis revealed that Lk remained to be potently independent [hazard ratio (HR), 4.21,
P
= 0.021), and the DFS was 58.3% in cases with Lk, while 88.7% in the counterpart. The multivariable logistic regression analysis revealed perioperative blood transfusion (
P
= 0.001) was independently associated with Lk. Intriguingly, Lk was closely associated with hematogenic recurrence (
P
= 0.003) rather than peritoneal or local recurrence. Although sustained increase of the serum C-reactive protein at 2 weeks after operation predicted poor prognosis, the mutitivariable analysis including the C-reactive protein level revealed that Lk still indicated the prognostic potential (HR, 3.70,
P
= 0.075).
Conclusions
The findings concluded that Lk may be a high risk for systemic recurrence in stage II CRC.</description><subject>Abdomen</subject><subject>Anastomotic Leak - epidemiology</subject><subject>Blood transfusions</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Colonoscopy</subject><subject>Colorectal cancer</subject><subject>Colorectal Neoplasms - epidemiology</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Disease</subject><subject>Disease-Free Survival</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Staging</subject><subject>Original Article</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Proteins</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical anastomosis</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kE1LxDAQhoMofv8ALxLw4Kk60yZNepTFj4UFwVXwFtJsulbbRpP0sP_eLKsigqeZYZ73TeYl5AThAgHEZUAsgWeAkGEhqoxtkX2UoshYmZfbqYcKs5zz5z1yEMIrAApAuUv2cgSZlHKf6KtBh-h6F1tDZ1a_6aWlEzdE39ZjtIFGR-OLpQ9teKON83S-CtH2CX6wZvTeDsbSdqDzuBZOp0nbOW9N1B2d6LT0R2Sn0V2wx1_1kDzdXD9O7rLZ_e10cjXLDCtEzCqohdY5NEbUuuCYSi0M15Jr3aSbBGs0A1mzelE1IMpFOsFwU9Uir0SVQ3FIzje-7959jDZE1bfB2K7Tg3VjUJJxUXJAnsizP-SrG_2QPqdQVsiASZknCjeU8S4Ebxv17tte-5VCUOv41SZ-Bes5xa9Y0px-OY91bxc_iu-8E5BvgJBWw9L6X0__6_oJlLOPJw</recordid><startdate>2011</startdate><enddate>2011</enddate><creator>Katoh, Hiroshi</creator><creator>Yamashita, Keishi</creator><creator>Wang, Guoqin</creator><creator>Sato, Takeo</creator><creator>Nakamura, Takatoshi</creator><creator>Watanabe, Masahiko</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2011</creationdate><title>Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer</title><author>Katoh, Hiroshi ; Yamashita, Keishi ; Wang, Guoqin ; Sato, Takeo ; Nakamura, Takatoshi ; Watanabe, Masahiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-90b7aa20fc7ba351c7bb7c5a85aaf87374fa408b4bd9f076d108c5c9b72979203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Abdomen</topic><topic>Anastomotic Leak - epidemiology</topic><topic>Blood transfusions</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Colonoscopy</topic><topic>Colorectal cancer</topic><topic>Colorectal Neoplasms - epidemiology</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Disease</topic><topic>Disease-Free Survival</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Staging</topic><topic>Original Article</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Proteins</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical anastomosis</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Katoh, Hiroshi</creatorcontrib><creatorcontrib>Yamashita, Keishi</creatorcontrib><creatorcontrib>Wang, Guoqin</creatorcontrib><creatorcontrib>Sato, Takeo</creatorcontrib><creatorcontrib>Nakamura, Takatoshi</creatorcontrib><creatorcontrib>Watanabe, Masahiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Katoh, Hiroshi</au><au>Yamashita, Keishi</au><au>Wang, Guoqin</au><au>Sato, Takeo</au><au>Nakamura, Takatoshi</au><au>Watanabe, Masahiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2011</date><risdate>2011</risdate><volume>15</volume><issue>1</issue><spage>120</spage><epage>129</epage><pages>120-129</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Purpose
In stage II colorectal cancer (CRC), high-risk patient selection is required, but no candidate markers have been elucidated. Our concern was whether anastomotic leakage (Lk) is a potential available clinicopathological factor for selecting high-risk stage II.
Methods
Two hundred seven patients with stage II CRC who underwent curative resection were analyzed. Clinical variables were tested for their relationship to survival.
Results
The 5-year disease-free survival rate (DFS) was 87.0%. The univariable prognostic analyses indicated that Lk (
P
= 0.003) was the only significant factor. The multivariable prognostic analysis revealed that Lk remained to be potently independent [hazard ratio (HR), 4.21,
P
= 0.021), and the DFS was 58.3% in cases with Lk, while 88.7% in the counterpart. The multivariable logistic regression analysis revealed perioperative blood transfusion (
P
= 0.001) was independently associated with Lk. Intriguingly, Lk was closely associated with hematogenic recurrence (
P
= 0.003) rather than peritoneal or local recurrence. Although sustained increase of the serum C-reactive protein at 2 weeks after operation predicted poor prognosis, the mutitivariable analysis including the C-reactive protein level revealed that Lk still indicated the prognostic potential (HR, 3.70,
P
= 0.075).
Conclusions
The findings concluded that Lk may be a high risk for systemic recurrence in stage II CRC.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21086058</pmid><doi>10.1007/s11605-010-1379-4</doi><tpages>10</tpages></addata></record> |
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| subjects | Abdomen Anastomotic Leak - epidemiology Blood transfusions Cancer therapies Chemotherapy Colonoscopy Colorectal cancer Colorectal Neoplasms - epidemiology Colorectal Neoplasms - surgery Disease Disease-Free Survival Emergency medical care Female Follow-Up Studies Gastroenterology Humans Incidence Japan - epidemiology Male Medical prognosis Medicine Medicine & Public Health Middle Aged Neoplasm Recurrence, Local - epidemiology Neoplasm Staging Original Article Patients Prognosis Proteins Retrospective Studies Risk Factors Surgery Surgical anastomosis Survival Rate - trends Time Factors |
| title | Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer |
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