Functional Outcomes in Rectal Cancer Patients After Surgical Treatment

Kang, Sung Bum; Kang, Sang‐Won

doi:10.1007/978-981-10-5143-2_19

Cited by 1 publication

(1 citation statement)

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“…Technical perioperative factors such as quality of TME, lymph node counts and margin status carry an evident relationship to future oncological outcomes. Other perioperative factors, such as unplanned conversion to open surgery, sphincter preservation and restoration of gastrointestinal continuity, do not affect oncological outcomes but nevertheless affect quality of life (QoL) factors that are important to patients, such as rates of incisional hernia, bowel dysfunction and presence of a permanent stoma [16–18]. Further, unplanned conversion is known to be an independent risk factor for increased postoperative morbidity and mortality [19–21].…”

Section: Introductionmentioning

confidence: 99%

Influence of neoadjuvant treatment strategy on perioperative outcomes in locally advanced rectal cancer

McFeetors,

O'Connell,

Choy

et al. 2024

Colorectal Disease

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AimNeoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer facilitates tumour downstaging and complete pathological response (pCR). The goal of neoadjuvant systemic chemotherapy (total neoadjuvant chemotherapy, TNT) is to further improve local and systemic control. While some patients forgo surgery, total mesorectal excision (TME) remains the standard of care. While TNT appears to be noninferior to nCRT with respect to short‐term oncological outcomes few data exist on perioperative outcomes. Perioperative morbidity including anastomotic leaks is associated with a negative effect on oncological outcomes, probably due to a delay in proceeding to adjuvant therapy. Thus, we aimed to compare conversion rates, rates of sphincter‐preserving surgery and anastomosis formation rates in patients undergoing rectal resection after either TNT or standard nCRT.MethodsAn institutional colorectal oncology database was searched from January 2018 to July 2023. Inclusion criteria comprised patients with histologically confirmed rectal cancer who had undergone neoadjuvant therapy and TME. Exclusion criteria comprised patients with a noncolorectal primary, those operated on emergently or who had local excision only. Outcomes evaluated included rates of conversion to open, sphincter‐preserving surgery, anastomosis formation and anastomotic leak.ResultsA total of 119 patients were eligible for inclusion (60 with standard nCRT, 59 with TNT). There were no differences in rates of sphincter preservation or primary anastomosis formation between the groups. However, a significant increase in conversion to open (p = 0.03) and anastomotic leak (p = 0.03) was observed in the TNT cohort.ConclusionIn this series TNT appears to be associated with higher rates of conversion to open surgery and higher anastomotic leak rates. While larger studies will be required to confirm these findings, these factors should be considered alongside oncological benefits when selecting treatment strategies.

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Section: Introductionmentioning

confidence: 99%