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Delayed surgery for rectal cancer patients receiving neoadjuvant chemoradiotherapy: a promising method in its infancy
Jia-Yuan Peng1, Jian-Zhong Di, Yu Wang
1Department of Surgery, The Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Background:
Neoadjuvant chemoradiotherapy (nCRT) is used to downstage locally advanced rectal cancer before surgery. Accumulating data suggest that tumor response to nCRT is time dependent. A delay between nCRT and surgery may increase the proportion of patients that achieve a favorable response. However, delayed surgery beyond 6-8 weeks may increase the technical difficulty, and the risks of surgical complications and recurrence or metastasis. This article briefly reviews the relevant literature to evaluate the efficiency and safety of delayed surgery.
Methods:
Two non-cohort studies and 10 cohort studies were reviewed. The results were analyzed and the limitations discussed.
Results:
Although debatable, the findings of the included studies are promising. Delayed surgery may increase the proportion of favorable tumor response without compromising prognosis. However, most of the studies were retrospective, which introduces bias into the evaluation.
Conclusion:
Delayed surgery is potentially useful, but this needs to be verified by further well-designed prospective trials.
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