Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study

Background: Anastomotic leak and subsequent organ/space surgical site infection (O/S-SSI) after colorectal cancer surgery are associated with poor short-term outcomes; however, the evidence regarding long-term outcomes is inconclusive. This population-based retrospective cohort study aimed to evalua...

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Autores: Matallana, Carlota, Manchon Walsh, Paula, Espin, Eloy, Pascual Damieta, Marta, Biondo, Sebastiano, Jiménez-Toscano, Marta, Borràs Andrés, Josep Maria, Badia, Josep M., Limón, Enrique, Font, Rebeca, Pera, Miguel, Aliste, Luisa
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/222336
Acesso em linha:https://hdl.handle.net/2445/222336
Access Level:acceso abierto
Palavra-chave:Cirurgia oncològica
Càncer colorectal
Tumors
Surgical oncology
Colorectal cancer
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spelling Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort studyMatallana, CarlotaManchon Walsh, PaulaEspin, EloyPascual Damieta, MartaBiondo, SebastianoJiménez-Toscano, MartaBorràs Andrés, Josep MariaBadia, Josep M.Limón, EnriqueFont, RebecaPera, MiguelAliste, LuisaCirurgia oncològicaCàncer colorectalTumorsSurgical oncologyColorectal cancerTumorsBackground: Anastomotic leak and subsequent organ/space surgical site infection (O/S-SSI) after colorectal cancer surgery are associated with poor short-term outcomes; however, the evidence regarding long-term outcomes is inconclusive. This population-based retrospective cohort study aimed to evaluate the association between O/S-SSI and both tumour recurrence and long-term survival after curative rectal cancer surgery. Methods: Data was obtained for all adults who underwent curative oncological resection of the rectum in the periods 2011-2012 and 2015-2016 (n = 2208) in Spain. Multivariable analysis (Cox proportional hazards model) was used to evaluate the effects of clinical and pathological characteristics, as well as the occurrence of O/S-SSI, on recurrence and survival. Results: In all, 2208 adults underwent curative rectal cancer resection, 1464 of whom were male (66.3%); the median patient age was 69.1 years. O/S-SSI occurred in 291 patients (13%). Independent predictors of recurrence included tumour stage III (hazard ratio (HR) 1.95, 95% confidence interval (c.i.) 1.06 to 3.58; P = 0.032), a positive resection margin (HR 4.03, 95% c.i. 2.58 to 6.29; P < 0.001), and poor quality mesorectal excision (HR 1.81, 95% c.i. 1.11 to 2.95; P = 0.018), but not O/S-SSI (HR 1.02, 95% c.i. 0.78 to 1.34; P = 0.888). However, O/S-SSI was independently associated with reduced overall survival at 1 year (HR 2.20, 95% c.i. 1.39 to 3.48; P < 0.001), 2 years (HR 1.75, 95% c.i. 1.25 to 2.43; P < 0.001), and 5 years (HR 1.33, 95% c.i. 1.05 to 1.68; P = 0.017). Conclusion: In this study, O/S-SSI had a negative impact on the long-term survival of patients who underwent rectal cancer surgery, but was not associated with increased tumour recurrence.Oxford University Press2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/222336Articles publicats en revistes (Ciències Clíniques)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1093/bjsopen/zraf052BJS Open, 2025, vol. 9, num.3https://doi.org/10.1093/bjsopen/zraf052cc-by (c) Matallana, C. et al., 2025http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2223362026-05-27T06:46:51Z
dc.title.none.fl_str_mv Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study
title Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study
spellingShingle Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study
Matallana, Carlota
Cirurgia oncològica
Càncer colorectal
Tumors
Surgical oncology
Colorectal cancer
Tumors
title_short Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study
title_full Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study
title_fullStr Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study
title_full_unstemmed Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study
title_sort Organ/space surgical site infection and long-term outcomes of rectal cancer surgery: retrospective population-based cohort study
dc.creator.none.fl_str_mv Matallana, Carlota
Manchon Walsh, Paula
Espin, Eloy
Pascual Damieta, Marta
Biondo, Sebastiano
Jiménez-Toscano, Marta
Borràs Andrés, Josep Maria
Badia, Josep M.
Limón, Enrique
Font, Rebeca
Pera, Miguel
Aliste, Luisa
author Matallana, Carlota
author_facet Matallana, Carlota
Manchon Walsh, Paula
Espin, Eloy
Pascual Damieta, Marta
Biondo, Sebastiano
Jiménez-Toscano, Marta
Borràs Andrés, Josep Maria
Badia, Josep M.
Limón, Enrique
Font, Rebeca
Pera, Miguel
Aliste, Luisa
author_role author
author2 Manchon Walsh, Paula
Espin, Eloy
Pascual Damieta, Marta
Biondo, Sebastiano
Jiménez-Toscano, Marta
Borràs Andrés, Josep Maria
Badia, Josep M.
Limón, Enrique
Font, Rebeca
Pera, Miguel
Aliste, Luisa
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cirurgia oncològica
Càncer colorectal
Tumors
Surgical oncology
Colorectal cancer
Tumors
topic Cirurgia oncològica
Càncer colorectal
Tumors
Surgical oncology
Colorectal cancer
Tumors
description Background: Anastomotic leak and subsequent organ/space surgical site infection (O/S-SSI) after colorectal cancer surgery are associated with poor short-term outcomes; however, the evidence regarding long-term outcomes is inconclusive. This population-based retrospective cohort study aimed to evaluate the association between O/S-SSI and both tumour recurrence and long-term survival after curative rectal cancer surgery. Methods: Data was obtained for all adults who underwent curative oncological resection of the rectum in the periods 2011-2012 and 2015-2016 (n = 2208) in Spain. Multivariable analysis (Cox proportional hazards model) was used to evaluate the effects of clinical and pathological characteristics, as well as the occurrence of O/S-SSI, on recurrence and survival. Results: In all, 2208 adults underwent curative rectal cancer resection, 1464 of whom were male (66.3%); the median patient age was 69.1 years. O/S-SSI occurred in 291 patients (13%). Independent predictors of recurrence included tumour stage III (hazard ratio (HR) 1.95, 95% confidence interval (c.i.) 1.06 to 3.58; P = 0.032), a positive resection margin (HR 4.03, 95% c.i. 2.58 to 6.29; P < 0.001), and poor quality mesorectal excision (HR 1.81, 95% c.i. 1.11 to 2.95; P = 0.018), but not O/S-SSI (HR 1.02, 95% c.i. 0.78 to 1.34; P = 0.888). However, O/S-SSI was independently associated with reduced overall survival at 1 year (HR 2.20, 95% c.i. 1.39 to 3.48; P < 0.001), 2 years (HR 1.75, 95% c.i. 1.25 to 2.43; P < 0.001), and 5 years (HR 1.33, 95% c.i. 1.05 to 1.68; P = 0.017). Conclusion: In this study, O/S-SSI had a negative impact on the long-term survival of patients who underwent rectal cancer surgery, but was not associated with increased tumour recurrence.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/222336
url https://hdl.handle.net/2445/222336
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1093/bjsopen/zraf052
BJS Open, 2025, vol. 9, num.3
https://doi.org/10.1093/bjsopen/zraf052
dc.rights.none.fl_str_mv cc-by (c) Matallana, C. et al., 2025
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Matallana, C. et al., 2025
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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