Neoadjuvant radiation and chemotherapy in rectal cancer does not increase postoperative complications

Int J Colorectal Dis. 2003 Nov;18(6):495-9. doi: 10.1007/s00384-003-0520-1. Epub 2003 Jul 15.

Abstract

Background and aims: Neoadjuvant radiation and chemotherapy in rectal cancer reduces local recurrences and increases the rate of conservative sphincter surgery. However, an increase in postoperative morbidity and mortality has also been observed. This study analyzed the operative difficulty and postoperative complications in patients with this treatment.

Patients and methods: Retrospective review of 103 patients with rectal cancer, divided into two groups: group A, 53 patients undergoing preoperative radiotherapy with 45 Gy combined with chemotherapy, and group B, 50 patients with rectal cancer who received surgery after diagnosis. Both groups were homogeneous. The two groups were compared for both technical difficulty, using intraoperative data and rate of complications.

Results: There were no statistically significant differences between the two groups with regard to intraoperative or postoperative data. In group A there were 20 complications in 17 patients (32%) and in group B 22 complications in 19 patients (38%). The rates of perineal wound infection were similar. The percentage of anastomotic leaks was higher in group A. A greater number of anterior resections was performed in group A.

Conclusion: Preoperative radiation and chemotherapy in rectal cancer does not increase postoperative complications and increases the rate of sphincter-preserving surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anal Canal / pathology
  • Anal Canal / surgery
  • Anastomosis, Surgical
  • Chemotherapy, Adjuvant / adverse effects
  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Postoperative Complications*
  • Radiotherapy, Adjuvant / adverse effects
  • Rectal Neoplasms / drug therapy*
  • Rectal Neoplasms / radiotherapy*
  • Rectal Neoplasms / surgery
  • Rectum / surgery
  • Retrospective Studies