Timing of surgery following neoadjuvant chemoradiation in rectal cancer: a retrospective analysis from an academic medical center

Seth Maliske; Justin Chau; Timothy Ginader; John Byrn; Sudershan Bhatia; Andrew Bellizzi; Daniel J Berg; Varun Monga

doi:10.21037/jgo.2019.02.02

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Timing of surgery following neoadjuvant chemoradiation in rectal cancer: a retrospective analysis from an academic medical center

Journal article

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Timing of surgery following neoadjuvant chemoradiation in rectal cancer: a retrospective analysis from an academic medical center

Seth Maliske, Justin Chau, Timothy Ginader, John Byrn, Sudershan Bhatia, Andrew Bellizzi, Daniel J Berg and Varun Monga

Journal of gastrointestinal oncology, Vol.10(4), pp.597-604

08/2019

DOI: 10.21037/jgo.2019.02.02

PMCID: PMC6657321

PMID: 31392039

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Abstract

Neoadjuvant chemoradiotherapy (nCRT) has been shown to achieve decreased local recurrence (LR) with lower toxicity in rectal cancer patients, but data confirming the optimal timing of surgery following this therapy is less robust. The University of Iowa Cancer Registry was queried to identify all patients with stages II-III rectal cancer who received nCRT and surgery from 2000 through 2012. Primary endpoints were time interval to surgery (TI), and overall survival (OS). Secondary endpoints included pathologic outcomes, perioperative morbidities and postoperative complications. Patient characteristics and treatment regimens were compared. Univariate Cox proportional hazard models were used to study the association between TI and OS. Associations of TI with secondary endpoints were tested using Chi-square tests of association. Eighty-seven patients presented with stages II-III rectal cancer. Mean TI was 9.92 weeks. There was no significant association between TI and OS when comparing <8 to ≥8 weeks (P=0.23) or when considering the interval as a continuous variable (P=0.85). Increased LOS [median 7.00 days, P=0.05, HR 1.03 (1.00-1.06)] did correlate with worse survival outcomes. Delaying surgery beyond 8 weeks was associated with increased risk for wound infection (P=0.05). OS was not influenced by longer intervals between nCRT and surgery. Delaying surgery beyond 8 weeks was associated with increased risk for wound infection.

timing of surgery

Rectal cancer

neoadjuvant chemoradiation

overall survival (OS)

Details

Title: Subtitle: Timing of surgery following neoadjuvant chemoradiation in rectal cancer: a retrospective analysis from an academic medical center
Creators: Seth Maliske - University of Iowa
Justin Chau - University of Iowa
Timothy Ginader - University of Iowa
John Byrn - University of Michigan
Sudershan Bhatia - University of Iowa
Andrew Bellizzi - University of Iowa
Daniel J Berg - University of Iowa
Varun Monga - University of Iowa
Resource Type: Journal article
Publication Details: Journal of gastrointestinal oncology, Vol.10(4), pp.597-604
DOI: 10.21037/jgo.2019.02.02
PMID: 31392039
PMCID: PMC6657321
NLM abbreviation: J Gastrointest Oncol
ISSN: 2078-6891
eISSN: 2219-679X
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 08/2019
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Pathology; Radiation Oncology; Internal Medicine
Record Identifier: 9984183983302771

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