{
  "abstract": "Background: 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. Methods: 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. Results: 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). Conclusions: 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.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Colon and Rectal surgery, Department of Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea",
    "Department of Medical Oncology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Youngbae Jeon"
    },
    {
      "affs": [
        1
      ],
      "name": "Sun Jin Sym"
    },
    {
      "name": "Won-Suk Lee"
    },
    {
      "name": "Jeong-Heum Baek"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/31vpjnyxanbbd.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0359416",
  "fulltext_url": null,
  "id": "31vpjnyxanbbd",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0359416",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Colorectal Cancer Surgical Treatments"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Histology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Histology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Clinical oncology/Cancer chemotherapy/Adjuvant chemotherapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Clinical oncology/Surgical oncology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancer treatment"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancer treatment/Cancer chemotherapy/Adjuvant chemotherapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancer treatment/Surgical oncology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Colorectal cancer"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Gastrointestinal tumors/Rectal cancer"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Clinical oncology/Cancer chemotherapy/Adjuvant chemotherapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Clinical oncology/Surgical oncology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pharmaceutics/Drug therapy/Chemotherapy/Cancer chemotherapy/Adjuvant chemotherapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Surgical resection"
    ]
  ],
  "openalex": "W7215086551",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0359416&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/31vpjnyxanbbd.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:37Z",
      "native_id": "10.1371/journal.pone.0359416",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0359416"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:oncology",
      "subfield": "oncology"
    }
  ],
  "title": "Long-term oncologic outcomes associated with clinically significant anastomotic leakage after curative colorectal cancer surgery: Stage- and location-stratified analyses",
  "title_text": "Long-term oncologic outcomes associated with clinically significant anastomotic leakage after curative colorectal cancer surgery: Stage- and location-stratified analyses",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:37Z",
  "url": "https://research.draconitic.com/paper/31vpjnyxanbbd",
  "venue": "PLOS One",
  "versions": []
}