Prognostic impact of anastomotic leakage in laparoscopic rectal cancer surgery after neoadjuvant chemotherapy

Abstract

We investigated the prognostic impact of anastmotic leakage in laparoscopic surgery neoadjuvant chemotherapy（NAC）for advanced rectal cancer. We included 50 patients who underwent laparoscopic low anterior resection of the rectum after NAC at Nippon Medical School Hospital from 2012 to 2019．Eight patients (16%) occurred anastomotic leakage, and the 3-year recurrence free survival for such patients were significantly worse than that of patients without anastomotic leakage (12.5% vs. 76.9%, P＜ 0.01). In multivariate analysis, anastomotic leakage (HR: 7.49, 95% C.I. 2.43-23.09, P＜0.01) and positive lateral lymph nodes at initial presentation (HR: 3.05, 95% C.I. 1.02-9.14, P=0.05) were identified as significant poor prognostic factor. In addition, anastomotic leakage tended to be more common in patients with poor response to NAC (P=0.10). Therefore, it is important that we strive to reduce anastomotic leakage for improvement of the prognosis of the patient with receiving NAC.