Role of the interval from completion of neoadjuvant therapy to surgery in postoperative morbidity in patients with locally advanced rectal cancer Journal Article


Authors: Roxburgh, C. S. D.; Strombom, P.; Lynn, P.; Gonen, M.; Paty, P. B.; Guillem, J. G.; Nash, G. M.; Smith, J. J.; Wei, I.; Pappou, E.; Garcia-Aguilar, J.; Weiser, M. R.
Article Title: Role of the interval from completion of neoadjuvant therapy to surgery in postoperative morbidity in patients with locally advanced rectal cancer
Abstract: Background: Increasing the interval from completion of neoadjuvant therapy to surgery beyond 8 weeks is associated with increased response of rectal cancer to neoadjuvant therapy. However, reports are conflicting on whether extending the time to surgery is associated with increased perioperative morbidity. Methods: Patients who presented with a tumor within 15 cm of the anal verge in 2009–2015 were grouped according to the interval between completion of neoadjuvant therapy and surgery: < 8 weeks, 8–12 weeks, and 12–16 weeks. Results: Among 607 patients, the surgery was performed at < 8 weeks in 317 patients, 8–12 weeks in 229 patients, and 12–16 weeks in 61 patients. Patients who underwent surgery at 8–12 weeks and patients who underwent surgery at < 8 weeks had comparable rates of complications (37% and 44%, respectively). Univariable analysis identified male sex, earlier date of diagnosis, tumor location within 5 cm of the anal verge, open operative approach, abdominoperineal resection, and use of neoadjuvant chemoradiotherapy alone to be associated with higher rates of complications. In multivariable analysis, male sex, tumor location within 5 cm of the anal verge, open operative approach, and neoadjuvant chemoradiotherapy administered alone were independently associated with the presence of a complication. The interval between neoadjuvant therapy and surgery was not an independent predictor of postoperative complications. Conclusions: Delaying surgery beyond 8 weeks from completion of neoadjuvant therapy does not appear to increase surgical morbidity in rectal cancer patients. © 2019, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 26
Issue: 7
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2019-07-01
Start Page: 2019
End Page: 2027
Language: English
DOI: 10.1245/s10434-019-07340-9
PUBMED: 30963399
PROVIDER: scopus
PMCID: PMC6579536
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Philip B Paty
    383 Paty
  2. Mithat Gonen
    729 Gonen
  3. Jose Guillem
    382 Guillem
  4. Martin R Weiser
    355 Weiser
  5. Garrett Nash
    144 Nash
  6. Jesse Joshua Smith
    58 Smith
  7. Patricio Bernardo Lynn
    10 Lynn
  8. Emmanouil Pappou
    7 Pappou
  9. Iris Hsin - chu Wei
    8 Wei