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International Journal of Colorectal Disease

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01-11-2003 | Original Article

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

Authors: G. Valero, J. A. Luján, Q. Hernández, M. de las Heras, E. Pellicer, A. Serrano, P. Parrilla

Published in: International Journal of Colorectal Disease | Issue 6/2003

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.

Dahlberg M, Glimelius B, Påhlman L (1999) Improved survival en reduction in local failure rates after preoperative radiotherapy. Evidence for the generalizability of the results of Swedish Rectal Cancer Trial. Ann Surg 229:493–497CrossRefPubMed

Grann A, Minsky BD, Cohen AM, et al (1997) Preliminary results of preoperative 5-fluorouracil, low-dose leucovorin, and concurrent radiation therapy for clinically resectable T3 rectal cancer. Dis Colon Rectum 40:515–522PubMed

Stockholm Colorectal Cancer Study Group (1996) Randomised study on preoperative radiotherapy in rectal carcinoma. Ann Surg Oncol 3:423–430PubMed

Medical Research Council Rectal Cancer Working Party (1996) Randomised trial of surgery alone versus radiotherapy followed by surgery for potentially operable locally advanced rectal cancer. Lancet 348:1605–1610CrossRefPubMed

Påhlman L, Glimelius B (1990) Pre- or postoperative radiotherapy in rectal and rectosigmoid carcinoma. Report from a randomized multicenter trial. Ann Surg 211:187–195PubMed

Chiari RS, Tyler DS, Anscher MS, et al (1995) Preoperative radiation and chemotherapy in the treatment of adenocarcinoma of the rectum. Ann Surg 221:778–787PubMed

Cammà C, Giunta M, Fiorica F, et al (2000) Preoperative radiotherapy for resectable rectal cancer. A meta-analysis. JAMA 284:1008–1015PubMed

Colorectal Cancer Collaborative Group (2001) Adjuvant radiotherapy for rectal cancer: a systematic overview of 8507 patients from 22 randomised trials. Lancet 358:1291–1304CrossRefPubMed

Holm T, Rutqvist LE, Johanson H, Cedermark B (1996) Postoperative mortality in rectal cancer treated with or without preoperative radiotherapy: causes and risk factors. Br J Surg 83:964–968PubMed

10.

Clavien PA, Sanabria JA, Strasberg SM (1992) Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 111:518–526PubMed

11.

Horn A, Halvorsen J, Dahl O (1990) Preoperative radiotherapy in operable rectal cancer. Dis Colon Rectum 33:823–828PubMed

12.

Frykholm GJ, Glimelius B, Påhlman L (1993) Preoperative or postoperative irradiation in adenocarcinoma of the rectum: final treatment results of a randomized trial and evaluation of late secondary effects. Dis Colon Rectum 36:564–572PubMed

13.

Shumate CR, Rich TA, Skibber JM, Ajani JA, Ota DM (1993) Preoperative chemotherapy and radiation therapy for locally advanced primary and recurrent rectal carcinoma. A report of surgical morbidity. Cancer 71:3690–3696PubMed

14.

Gérard A, Buyse M, Nordlinger B, et al (1988) Preoperative radiotherapy as adjuvant treatment in rectal cancer. Final results of a randomized study of the european organization for research and treatment of cancer (EORTC). Ann Surg 208:606–614PubMed

15.

Cedermark B, Johansson H, Rutqvist LE, Wilking N (1995) The Stockholm I trial of preoperative short term radiotherapy in operable rectal carcinoma. A prospective randomized trial. Cancer 75:2269–2275PubMed

16.

Pucciarelli S, Toppan P, Friso ML, et al (1999) Preoperative combined radiotherapy and chemotherapy for rectal cancer does not affect early postoperative morbidity and mortality in low anterior resection. Dis Colon Rectum 42:1276–1283PubMed

17.

Janjan NA, Khoo VS, Rich TA, et al (1998) Locally advanced rectal cancer: surgical complications after infusional chemotherapy and radiation therapy. Radiology 206:131–136PubMed

18.

Roberson SH, Heron HC, Kermen HD, Bloom TS (1985) Is anterior resection of the rectosigmoid safe after preoperative radiation? Dis Colon Rectum 28:254–259

Title: Neoadjuvant radiation and chemotherapy in rectal cancer does not increase postoperative complications
Authors: G. Valero
J. A. Luján
Q. Hernández
M. de las Heras
E. Pellicer
A. Serrano
P. Parrilla
Publication date: 01-11-2003
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 6/2003
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-003-0520-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background and aims

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and aims

Patients and methods

Results

Conclusion

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