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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2008

01-10-2008 | Gastrointestinal Oncology

An Interval >7 Weeks between Neoadjuvant Therapy and Surgery Improves Pathologic Complete Response and Disease–Free Survival in Patients with Locally Advanced Rectal Cancer

Authors: Hagit Tulchinsky, MD, Einat Shmueli, MD, Arie Figer, MD, Joseph M. Klausner, MD, Micha Rabau, MD

Published in: Annals of Surgical Oncology | Issue 10/2008

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Abstract

Background

We assessed whether the time interval between neoadjuvant therapy and surgery affects the operative and postoperative morbidity and mortality, the pathologic complete response (pCR) rate, and disease recurrence in locally advanced rectal cancer.

Methods

One–hundred and thirty-two patients with locally advanced low– and mid–rectal cancer underwent neoadjuvant chemoradiation followed by radical resection (October 2000 to December 2006). Data on the neoadjuvant regime, neoadjuvant–surgery interval, final pathology, type of operation, operative time, intraoperative blood transfusions, postoperative complications, length of hospital stay, disease recurrence, and mortality were reviewed. The patients were divided into two groups according to the neoadjuvant–surgery interval: ≤7 weeks (group A, n = 48), and >7 weeks (group B, n = 84).

Results

The groups were demographically comparable except for the group A patients being younger at operation. The median interval between chemoradiation and surgery was 56 days (range 13–173 days). Thirty-seven patients (28%) had a pCR and near pCR. Fifty three patients (40%) had complications. There was no in-hospital mortality. Surgery type, operative time, number of intraoperative blood transfusions, postoperative complications, and length of hospitalization were not influenced by the interval length. The pCR and near pCR rates were higher with longer interval: 17% in group A, 35% in group B (P = 0.03). Patients operated at an interval >7 weeks had significantly better disease–free survival (P = 0.05).

Conclusions

A neoadjuvant–surgery interval >7 weeks was associated with higher rates of pCR and near pCR, decreased recurrence and improved disease–free survival.
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Metadata
Title
An Interval >7 Weeks between Neoadjuvant Therapy and Surgery Improves Pathologic Complete Response and Disease–Free Survival in Patients with Locally Advanced Rectal Cancer
Authors
Hagit Tulchinsky, MD
Einat Shmueli, MD
Arie Figer, MD
Joseph M. Klausner, MD
Micha Rabau, MD
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9892-3

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