Radiation to the Gastric Fundus Increases the Risk of Anastomotic Leakage After Esophagectomy

This retrospective single institution study evaluated the relationship between radiation dose to the gastric fundus and the incidence of esophageal anastomotic leak after esophagectomy for cancer.  The leak rate was 26%.  Pts with a leak had a significantly higher RT dose to the gastric fundus.  Using a cut point of 31.4 Gy, leak rates were 43% vs 15% for the high and low dose radiation exposure.  Radiation dose was an independent predictor of anastomotic leak in multivariable analysis.