2026-10-12T16:13:01Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34048621 2026-10-01T17:34:58Z category_7 category_12 category_14 category_21 category_24 category_811 category_61 category_62 category_64 category_132 category_134 portal_5 item_type_1 month_year_10_2026

<p>Flowchart of the patient selection process.</p> Youngbae Jeon (17655883) Sun Jin Sym (6504101) Won-Suk Lee (530818) Jeong-Heum Baek (6504104) Medicine Cell Biology Molecular Biology Biotechnology Evolutionary Biology Mathematical Sciences not elsewhere classified Developmental Biology Marine Biology Cancer Infectious Diseases Virology underwent curative surgery substantial postoperative morbidity significant interaction indicates significant effect modification metastatic colorectal adenocarcinoma formal interaction analyses colorectal cancer surgery 923 &# 8211 812 &# 8211 term oncologic outcomes including treatment era although poorer survival clinically significant al stage iii subgroup stage iii disease term survival including stage overall survival free survival xlink "> tumor stage specific patterns specific findings performed according overall cohort multivariable adjustment lower 5 grade b exploratory rather c leakage 260 ). 007 ). <div> <p>Background</p><p>Clinically significant anastomotic leakage (AL) after colorectal cancer surgery is associated with substantial postoperative morbidity, but its long-term oncologic impact remains uncertain. We evaluated the association of AL with long-term survival, including stage- and location-specific patterns, after curative colorectal cancer surgery.</p> <p>Methods</p><p>We retrospectively reviewed consecutive patients who underwent curative surgery for non-metastatic colorectal adenocarcinoma between 2004 and 2018. Clinically significant AL was defined as grade B or C leakage. Overall survival (OS) and disease-free survival (DFS) were assessed using Kaplan–Meier and multivariable Cox regression analyses. Subgroup and formal interaction analyses were performed according to tumor stage and location.</p> <p>Results</p><p>Among 2,122 patients, 63 (3.0%) developed clinically significant AL. After multivariable adjustment, including treatment era, AL was not independently associated with OS (HR, 1.581; 95% CI, 0.923–2.707; p = 0.095) or DFS (HR, 1.325; 95% CI, 0.812–2.161; p = 0.260). In stage III disease, patients with AL had lower 5-year OS (56.3% vs. 76.3%; p = 0.005) and DFS (43.9% vs. 68.4%; p = 0.007). However, formal interaction testing showed no significant effect modification by tumor stage (OS, p for interaction = 0.132; DFS, p for interaction = 0.141) or tumor location (OS, p for interaction = 0.775; DFS, p for interaction = 0.748).</p> <p>Conclusions</p><p>Clinically significant AL was not independently associated with long-term oncologic outcomes in the overall cohort. Although poorer survival was observed in the stage III subgroup, the absence of significant interaction indicates that these stage- and location-specific findings should be interpreted as exploratory rather than evidence of differential AL effects.</p></div> 2026-10-01T17:34:52Z Image Figure 10.1371/journal.pone.0359416.g001 https://figshare.com/articles/figure/_p_Flowchart_of_the_patient_selection_process_p_/34048621 CC BY 4.0