Long‐term prognostic impact of surgical complications in the German Rectal Cancer Trial CAO/ARO/AIO‐94. BJS 2018; 105: 1510-1518.
Published: 30th May 2018
Authors: T. Sprenger, T. Beißbarth, R. Sauer, J. Tschmelitsch, R. Fietkau, T. Liersch et al.
The influence of postoperative complications on survival in patients with locally advanced rectal cancer undergoing combined modality treatment is debatable. This study evaluated the impact of surgical complications on oncological outcomes in patients with locally advanced rectal cancer treated within the randomized CAO/ARO/AIO‐94 (Working Group of Surgical Oncology/Working Group of Radiation Oncology/Working Group of Medical Oncology of the Germany Cancer Society) trial.
Patients were assigned randomly to either preoperative chemoradiotherapy (CRT) followed by total mesorectal excision (TME) or postoperative CRT between 1995 and 2002. Anastomotic leakage and wound healing disorders were evaluated prospectively, and their associations with overall survival, and distant metastasis and local recurrence rates after a long‐term follow‐up of more than 10 years were determined. Medical complications (such as cardiopulmonary events) were not analysed in this study.
A total of 799 patients were included in the analysis. Patients who had anterior or intersphincteric resection had better 10‐year overall survival than those treated with abdominoperineal resection (63·1
Surgical complications were associated with adverse oncological outcomes in this trial.Full text
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