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• W3084352017 abstract "Summary Introduction Long-term survival after curative surgery for oesophageal cancer surgery remains poor, and the prognostic impact of anastomotic leak (AL) remains unknown. A meta-analysis was conducted to investigate the impact of AL on long-term survival. Methods A systematic electronic search for articles was performed for studies published between 2001 and 2020 evaluating the long-term oncological impact of AL. Meta-analysis was performed using the DerSimonian-Laird random-effects model to compute hazard ratios and 95% confidence intervals. Results Nineteen studies met the inclusion criteria, yielding a total of 9885 patients. Long-term survival was significantly reduced after AL (HR: 1.79, 95% CI: 1.33–2.43). AL was associated with significantly reduced overall survival in studies within hospital volume Quintile 1 (HR: 1.35, 95% CI: 1.12–1.63) and Quintile 2 (HR: 1.83, 95% CI: 1.35–2.47). However, no significant association was found for studies within Quintile 3 (HR: 2.24, 95% CI: 0.85–5.88), Quintile 4 (HR: 2.59, 95% CI: 0.67–10.07), and Quintile 5 (HR: 1.29, 95% CI: 0.92–1.81). AL was significantly associated with poor long-term survival in patients with associated overall Clavien Dindo Grades 1–5 (HR: 2.17, 95% CI: 1.31–3.59) and severe Clavien Dindo Grades 3–5 (HR: 1.42, 95% CI: 1.14–1.78) complications. Conclusions AL has a negative prognostic impact on long-term survival after restorative resection of oesophageal cancers, particularly in low-volume centers. Future efforts must be focused on strategies to minimize the septic and immunological response to AL with early recognition and treatment thus reducing the impact on long-term survival." @default.
• W3084352017 created "2020-09-14" @default.
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• W3084352017 date "2020-09-08" @default.
• W3084352017 modified "2023-09-23" @default.
• W3084352017 title "Effect of anastomotic leaks on long-term survival after oesophagectomy for oesophageal cancer: systematic review and meta-analysis" @default.
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• W3084352017 doi "https://doi.org/10.1093/dote/doaa085" @default.
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