Peripheral leucocyte count variations in rectal cancer treatment

Area of Science:

• Oncology
• Surgical Oncology
• Radiotherapy Research

Background:

• Curative surgery for rectal cancer can have increased mortality if not performed promptly after neoadjuvant radiotherapy.
• Neoadjuvant radiotherapy's potential to suppress peripheral leucocyte counts has been hypothesized as a contributing factor.

Purpose of the Study:

• To investigate the impact of neoadjuvant radiotherapy on peripheral leucocyte counts in rectal cancer patients.
• To assess the relationship between radiotherapy-induced leucocyte changes, postoperative complications, and survival outcomes.

Main Methods:

• Retrospective analysis of 926 rectal cancer patients (1993-2004) from Swedish registries.
• Leucocyte counts and mortality data were analyzed, with 310 patients receiving radiotherapy.
• Mean follow-up duration was 2.8 years.

Main Results:

• A significant suppression of leucocytes was observed in irradiated patients compared to non-irradiated controls (p<0.05).
• Long-course radiotherapy demonstrated a better postoperative leucocyte response.
• Irradiated patients with a low postoperative to preoperative leucocyte ratio experienced higher complication rates.

Conclusions:

• Neoadjuvant radiotherapy impairs postoperative leucocytosis, irrespective of the surgical latency period.
• Suppressed leucocyte response in irradiated patients correlates with significantly increased complication rates.
• The study's median follow-up was too short to definitively assess survival impact in radiotherapy groups.