Time to Surgery Following Short-Course Radiotherapy in Rectal Cancer and its Impact on Postoperative Outcomes. A...

Area of Science:

• Oncology
• Surgical Oncology
• Radiotherapy

Background:

• Preoperative short-course radiotherapy (SCRT) is a standard treatment for rectal cancer.
• Optimal timing between SCRT and surgery is debated due to limited and conflicting evidence.
• Investigating the impact of the SCRT-surgery interval on postoperative outcomes is crucial for treatment optimization.

Observation:

• A large cohort of 3469 rectal cancer patients treated with SCRT in the UK's National Health Service was analyzed.
• The time from SCRT to surgery varied, with 76% of patients operated on within 0-7 days.
• Postoperative outcomes, including mortality, reoperation rates, length of stay, and 1-year survival, were assessed against the interval length.

Findings:

• No significant differences in 30-day postoperative mortality, returns to theatre, length of stay, or 1-year survival were observed based on the interval between SCRT and surgery.
• Patient characteristics influenced the timing of surgery post-SCRT.
• The study found no evidence that longer intervals between SCRT and surgery improved postoperative outcomes.

Implications:

• The findings suggest that the time interval between SCRT and surgery does not critically impact short-term or 1-year postoperative outcomes in rectal cancer patients.
• This population-level, real-world evidence can help inform clinical decision-making regarding surgical scheduling after SCRT.
• Further research may focus on other factors influencing outcomes in rectal cancer patients undergoing SCRT and surgery.