Perioperative Complications After Proctectomy for Rectal Cancer: Does Neoadjuvant Regimen Matter?

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Oncology

Background:

• Neoadjuvant treatment strategies for rectal cancer aim to improve outcomes.
• Short-course neoadjuvant therapy (SC-TNT) is an alternative to neoadjuvant chemoradiotherapy (CRT).
• Concerns exist that SC-TNT may increase operative difficulty and complication risk.

Purpose of the Study:

• To investigate the association between neoadjuvant SC-TNT and perioperative complications.
• To compare surgical complication rates between SC-TNT and CRT in rectal cancer patients.

Main Methods:

• Retrospective cohort study of 415 patients undergoing proctectomy for nonmetastatic rectal cancer.
• Comparison of severe postoperative morbidity (POM) and secondary outcomes between SC-TNT and CRT groups.
• Univariate and logistic regression analyses were performed.

Main Results:

• No significant difference in severe POM (9.6% SC-TNT vs. 12.0% CRT, P=0.46) or overall POM (39.7% SC-TNT vs. 37.5% CRT, P=0.64).
• Multivariate analysis showed no association between neoadjuvant regimen and severe POM (OR 0.42, 95% CI 0.04-4.70, P=0.48).
• No significant association found with secondary outcomes like intraoperative complications or resection margins.

Conclusions:

• SC-TNT is not associated with a significantly increased risk of POM compared to CRT in rectal cancer patients.
• The findings suggest SC-TNT is a safe alternative regarding perioperative complications.
• Further research may explore long-term oncological outcomes.