{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:58:08Z","timestamp":1790924288287,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Anastomotic leak (AL) is a serious complication following colon cancer resection, but its long\u2010term impact on survival and recurrence remains uncertain.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the association between AL and postoperative outcomes, including overall survival (OS), replase\u2010free survival (RFS), and cancer\u2010specific survival (CSS), and to identify factors associated with increased risk of leak.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study included 2217 patients with histologically confirmed Stage I\u2013III colon adenocarcinoma who underwent curative\u2010intent resection with primary anastomosis across three tertiary centres (2009\u20132025). Patients with benign pathology, carcinoma in situ (Stage 0), metastatic disease, or missing follow\u2010up data were excluded. ALs were defined as clinically and\/or radiologically confirmed disruptions occurring within 30 days postoperatively. No leaks were observed beyond this period. Outcomes were compared using Kaplan\u2013Meier estimates and Cox regression models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n ALs, either clinical or radiological, occurred in 2.0% of patients (\n n<\/jats:italic>\n \u2009=\u200944). Leaks were associated with significantly increased 30\u2010day mortality (6.8% vs. 0.4%,\n p<\/jats:italic>\n \u2009<\u20090.001), reoperation (86.4% vs. 3.4%,\n p<\/jats:italic>\n \u2009<\u20090.001), and hospital stay (median 21 vs. 7 days,\n p<\/jats:italic>\n \u2009<\u20090.001). In multivariable analysis, AL independently predicted 30\u2010day mortality (AOR 13.6, 95% CI 9.9\u201318.6) and return to theatre (AOR 396.2, 95% CI 218.8\u2013717.4). AL was associated with worse OS and DFS, but not CSS (\n p<\/jats:italic>\n \u2009=\u20090.66).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n AL is an independent predictor of postoperative morbidity and long\u2010term nononcologic mortality in colon cancer patients. While OS and DFS were significantly reduced, CSS remained unaffected, a unique finding that challenges assumptions about leak\u2010related oncologic progression. These results suggest that excess mortality stems from systemic complications and care disruption rather than cancer recurrence. Preventive strategies and early leak detection in high\u2010risk patients are essential to improving outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jso.70100","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T12:56:02Z","timestamp":1758545762000},"page":"1250-1256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Anastomotic Leak Following Colon Cancer Resection: An Independent Predictor of Non\u2010Oncologic Mortality and Morbidity"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7489-8624","authenticated-orcid":false,"given":"Rathin","family":"Gosavi","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Cabrini Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cabrini Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cabrini Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Wilkins","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cabrini Hospital Melbourne Victoria Australia"},{"name":"Department of Biochemistry and Molecular Biology Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Asghari\u2010Jafarabadi","sequence":"additional","affiliation":[{"name":"Cabrini Research Cabrini Hospital Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"McMurrick","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cabrini Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Colon Cancer","author":"Menon G.","year":"2025"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ciresp.2022.06.014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000002454"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2019.10.038"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182a6f2fc"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.13648"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000471"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000041"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-023-10863-w"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.0198"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-021-02079-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i34.5017"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-021-03854-5"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2014.10.052"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000958"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70100","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T08:28:23Z","timestamp":1761985703000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.70100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,22]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/jso.70100"],"URL":"https:\/\/doi.org\/10.1002\/jso.70100","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,22]]},"assertion":[{"value":"2025-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}