Delayed surgery after radio-chemotherapy for rectal adenocarcinoma is protective for anastomotic dehiscence: a single-center observational retrospective cohort study

Updates Surg. 2020 Jun;72(2):469-475. doi: 10.1007/s13304-020-00770-1. Epub 2020 Apr 18.

Abstract

Ideal time interval between end of neoadjuvant radio-chemotherapy (NRCT) and surgery for rectal cancer is debated. Effect that different time intervals have on postoperative complications with particular regard to anastomotic dehiscence (AD) was evaluated on 167 patients who underwent surgery after long-course NRCT. Three different time intervals were considered: (0-42; 43-56; > 57 days). A time interval > 57 days was significantly protective for AD (p = 0.04, Odds ratio = 0.35; 95% CI 0.1254-0.9585) without influence on early oncological outcomes. Optimal time interval after end of NRCT and surgery may help achieving the best pathological response with lowest postoperative morbidity.Trial registration number: Clinical Trial. Gov NCT04013347. https://clinicaltrials.gov/ct2/results?cond=&term=NCT04013347&cntry=&state=&city=&dist= ).

Keywords: Delayed surgery; Neoadjuvant; Rectal cancer surgery; Timing.

Publication types

  • Observational Study

MeSH terms

  • Adenocarcinoma / surgery*
  • Adenocarcinoma / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / adverse effects*
  • Anastomosis, Surgical / methods*
  • Chemoradiotherapy, Adjuvant*
  • Cohort Studies
  • Digestive System Surgical Procedures / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morbidity
  • Neoadjuvant Therapy* / adverse effects
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Rectal Neoplasms / surgery*
  • Rectal Neoplasms / therapy
  • Retrospective Studies
  • Surgical Wound Dehiscence / epidemiology*
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Dehiscence / prevention & control*
  • Time Factors
  • Time-to-Treatment*

Associated data

  • ClinicalTrials.gov/NCT04013347