Delayed Surgical Resection After Long-course Neoadjuvant Chemoradiotherapy in Rectal Cancer: Single Center Experience

Abstract

Introduction:The aim of this study was to evaluate whether delayed rectal cancer surgery after long-course neoadjuvant concomitant chemoradiotherapy was effective on pathological complete response (pCR), disease-free survival (DFS), and overall survival (OS).Methods:A total of 112 patients with rectal carcinoma diagnosed at the Radiation Oncology Clinic between 2011 and 2017 were retrospectively analyzed. We compared the outcomes of patients who were operated on greater than >9 weeks (delayed surgery) and less than <8 weeks (early surgery) after completion of neoadjuvant chemoradiotherapy.Results:When we compared the delayed and early surgery groups, pCR rate was higher in the Delayed surgery group (18.2% vs. 5.2%, p=0.032). Tumor regression was found to be close to statistical significance in the delayed surgery group (p=0.050). The decrease in postoperative T stage was found to be statistically significant in the delayed surgery group (p=0.007). When the study was completed, the patient group who underwent delayed surgery had a longer life and this was statistically significant (p=0.044). The OS rate (p=0.004) and DFS rate (p=0.003) was statistically significant in the delayed surgery group.Conclusion:Delaying surgery after neoadjuvant chemoradiotherapy increases the pCR rate, DFS and OS.

Keywords

• rectal cancer
• delayed surgery
• neoadjuvant longcourse radiotherapy
• chemotherapy