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Anastomotic leak does not worsen oesophageal cancer outcomes

Anastomotic leak (AL) does not affect long-term oncological outcomes in patients with oesophageal cancer, says a study published in the Annals of Surgical Oncology.

The study evaluated 1063 consecutive patients undergoing a two-stage, two-field transthoracic oesophagectomy at the Northern Oesophagogastric Unit at the Royal Victoria Infirmary in Newcastle upon Tyne, between 1997 and 2016 were evaluated.

Approximately 8 per cent of patients developed AL, 45 per cent of whom had severe oesophageal AL (SEAL). SEAL was defined as ALs associated with Clavien-Dindo grade III/IV complications.

SEAL was found to be associated with a prolonged critical care stay compared with non-severe leak (NSL) and no leak (median, 8 vs 3 vs 2 days; P<.001). SEAL was also associated with prolonged hospital stay (median, 43 vs 27 vs 15 days; P<.001) compared with NSL or no AL.

However, there were no significant differences in the number of lymph nodes harvested and rates of R1 resection between groups. Overall survival (OS) and recurrence-free survival (RFS) were not affected by either NSL or SEAL. Cox multivariate regression showed NSL and SEAL were not independently associated with OS and RFS.

The authors say, contrary to previous reports, ALs do not compromise long-term outcomes and are unlikely to have a detrimental oncological impact.


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