Long-Term Oncological Outcomes Following Anastomotic Leakage After Colorectal Cancer Surgery: A Retrospective Monocenter Trial

BACKGROUND AND OBJECTIVES: Colorectal cancer (CRC) ranks among the most common cancers worldwide. One of the most severe postoperative complications is an anastomotic leakage (AL). The aim of this study was to investigate the impact of AL on the long-term oncologic outcome. METHODS: All patients who underwent curative surgery for CRC at the Department of Surgery at the University Hospital in Mannheim between January 2011 and June 2016 were retrospectively analyzed. The primary endpoint was the overall survival (OS). RESULTS: Between January 2011 and June 2016, a total of 504 patients were included in the study. The median follow-up was 42 months. We found an AL incidence of 11.1% (n = 56) with the following risk factors: age ≤ 65 (p = 0.03) and location of the tumor in the rectum, especially mid-rectum (p = 0.012). Patients with AL were less likely to have adjuvant chemotherapy (p = 0.002). AL had no significant impact on the OS (p = 0.09). Patients with AL had a significantly higher 90-day mortality (p = 0.002), whereas there was no significant impact on local or distant recurrence. CONCLUSION: In our cohort, age ≤ 65 and a cancer location in the mid-rectum were risk factors for AL. However, our results did not demonstrate a significant influence of AL on the oncological long-term outcome.