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Published on: February 12, 2022
Does neoadjuvant chemoradiotherapy increase the effect of lateral lymph node dissection on urogenital function?
Yujuan Jiang1, Sicheng Zhou1, Wei Pei1
1Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Neoadjuvant chemoradiotherapy (nCRT) did not worsen urogenital function in rectal cancer patients undergoing lateral lymph node dissection (LLND). Tumor proximity to the anal verge predicted urinary issues, while age predicted sexual dysfunction after surgery.
Area of Science:
- Oncology
- Surgical Gastroenterology
- Urology
Background:
- Assessing the impact of neoadjuvant chemoradiotherapy (nCRT) on urogenital function in rectal cancer patients after lateral lymph node dissection (LLND) is crucial.
- Investigating potential predictors of urogenital dysfunction post-treatment is essential for patient management.
Purpose of the Study:
- To determine the incidence of urogenital dysfunction in rectal cancer patients following total mesorectal excision (TME) plus LLND, with or without nCRT.
- To identify factors predicting urogenital dysfunction in this patient cohort.
Main Methods:
- A retrospective review of 106 rectal cancer patients who underwent TME + LLND between January 2015 and December 2020.
- Patients were stratified into two groups: those who received nCRT (n=51) and those who did not (n=55).
- Urogenital function was assessed using validated questionnaires, including the International Prostatic Symptom Score (IPSS) and the International Index of Erectile Function (IIEF).
Main Results:
- Neoadjuvant chemoradiotherapy (nCRT) showed no significant association with increased urinary or male sexual dysfunction.
- Univariable analysis identified tumor distance from the anal verge (≤4 cm) and type of operation as risk factors for urinary dysfunction.
- Age and type of LLND were candidate risk factors for male sexual dysfunction, with age being an independent predictor in multivariable analysis.
Conclusions:
- Neoadjuvant chemoradiotherapy (nCRT) does not appear to have an additive detrimental effect on genitourinary function in rectal cancer patients undergoing LLND.
- Tumor distance from the anal verge is an independent predictor of urinary dysfunction.
- Patient age is an independent predictor of sexual dysfunction following rectal cancer surgery with LLND.
