Does Neoadjuvant Chemoradiotherapy Have an Additional Effect to Lateral Pelvic Lymph Node Dissection for Rectal...

Area of Science:

• Surgical Oncology
• Radiation Oncology
• Gastrointestinal Oncology

Background:

• Total mesenteric excision (TME) with lateral pelvic lymph node dissection (LLND) is standard for advanced low rectal cancer in Japan.
• Neoadjuvant (chemo)radiotherapy (nCRT) is increasingly used with LLND to enhance outcomes.

Purpose of the Study:

• To evaluate the benefits of incorporating nCRT into the TME with LLND procedure.
• To assess the impact of nCRT on local recurrence rates in advanced low rectal cancer.

Main Methods:

• Retrospective review of 72 patients with advanced low rectal cancer treated between 2006-2019.
• Comparison of clinicopathological data and local recurrence risk factors between patients with and without nCRT.
• Multivariate analysis to identify independent risk factors for local recurrence.

Main Results:

• 57 patients received nCRT; 15 did not. No significant differences in clinicopathological characteristics, except clinical T stage.
• Postoperative complications were statistically insignificant between groups.
• The 5-year local recurrence rate was significantly lower with nCRT (4.0% vs. 26.6%, p=0.002).

Conclusions:

• Neoadjuvant chemoradiotherapy significantly reduces local recurrence in advanced low rectal cancer patients undergoing TME with LLND.
• Absence of nCRT is an independent risk factor for local recurrence in this patient cohort.