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Preoperative Chemoradiotherapy Effects on Anastomotic Leakage After Rectal Cancer Resection: A Propensity Score Matching Analysis

 Jee Suk Chang  ;  Ki Chang Keum  ;  Nam Kyu Kim  ;  Seung Hyuk Baik  ;  Byung So Min  ;  Hyuk Huh  ;  Chang Geol Lee  ;  Woong Sub Koom 
 ANNALS OF SURGERY, Vol.259(3) : 516-521, 2014 
Journal Title
Issue Date
Anastomosis, Surgical/methods ; Anastomotic Leak/diagnosis ; Anastomotic Leak/epidemiology* ; Anastomotic Leak/prevention & control ; Chemoradiotherapy ; Colonoscopy ; Digestive System Surgical Procedures/methods* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Preoperative Care/methods* ; Prognosis ; Propensity Score ; Rectal Neoplasms/therapy* ; Republic of Korea/epidemiology ; Retrospective Studies ; Tomography, X-Ray Computed
anastomotic leakage ; low anterior resection ; preoperative chemoradiotherapy ; propensity score matching ; rectal cancer
OBJECTIVE: To assess the effects of preoperative chemoradiotherapy (CRT) on anastomotic leakage (AL) after rectal cancer resection, using propensity score matching. BACKGROUND: Conflicting data have emerged over the last decade regarding the effect of preoperative CRT on AL. METHODS: We reviewed 1437 consecutive patients with rectal cancer who underwent low anterior resection (LAR) at our institution between 2005 and 2012. AL evaluated as grade C was the primary endpoint, as proposed by the International Study Group of Rectal Cancer in 2010. The patients were treated with (n = 360) or without (n = 1077) preoperative CRT. The total radiation dose was 50.4 Gy in 28 fractions. Multivariate and propensity score matching analyses were used to compensate for the differences in some baseline characteristics. RESULTS: The preoperative CRT group contained more patients with the following characteristics, older age, male sex, smoker, advanced stage tumor, lower/mid rectal tumor location, ultra-LAR, and diverting stoma, than the non-preoperative CRT group (all Ps < 0.05). Postoperative AL occurred in 91 patients (6.3%). Before propensity score matching, the incidence of AL in patients with or without preoperative CRT was 7.5% and 5.9%, respectively (P = 0.293). After propensity score matching, the 2 groups were nearly balanced except for the initial stage and the length of the surgeon's career, and the incidence of AL in patients with or without preoperative CRT was 7.5% and 8.1%, respectively (P = 0.781). CONCLUSIONS: We did not observe that preoperative CRT increased the risk of postoperative AL after LAR in patients with rectal cancer, using propensity score matching analysis.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Chang, Jee Suk Paul(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
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