Potential risk factors

Table 1. Factors reported to be associated or not associated with anastomotic and/or intraluminal recurrence risk specifically. Note that a factor may be present in both categories. Risk factors are shown for rectal and colon cancer separately, if reported accordingly.

 

Potential risk factor for anastomotic and/or intraluminal recurrence

Factors not associated with anastomotic and/or intraluminal recurrence risk

Tumor size,

nodal involvement

Rectal: tumor >5-6 cm1,2, T3-T42,3, N22

Rectal: T and N stage4,5 Colon: T and N stage2

Histology

CRC: mucinous type1,2 Colon: PNI+2, LVI+2,6 Rectal ca: LVI+5

CRC: histological grade2,3,5,7 Rectal: LVI+2,4,6, PNI+3,4

Resection margin

Rectal: distal margin <8 mm5, distal margin involvement3

Rectal: clear distal margin <10 mm2-4,8 circumferential margin size3,4 Colon: clear distal margin <10 mm2

Surgical technique

Rectal: no intraoperative rectal washout9,10

Rectal: no intraoperative rectal washout2,11 use of stapler11,12 minimally invasive approach2

Adjuvant treatment

Rectal: neoadjuvant treatment4,13,14

Rectal: neoadjuvant treatement2,3 adjuvant treatment2,3,5 Colon: adjuvant treatment1

Perioperative complications

 

CRC: emergency surgery, bowel perforation, obstruction, anastomotic leakage1,2

Other factors

Colon: age1 Rectum: preoperative CEA level2 CRC: preoperative CEA level1

Rectal: age1,2,4 CRC: sex1

CRC, colorectal cancer; LVI, lymphovascular invasion; PNI, perineural invasion; CEA, carcinoembryonic antigen.