Outcome of rectal cancer after radiotherapy with a long or short waiting period before surgery, a descriptive clinical study

Abstract

Background: Radiotherapy and surgery have shown to improve local control and survival in rectal cancer.There are two applied schedules; radiotherapy with a long or short waiting period before surgery. The effect on survival and recurrence of both schedules was studied.Methods: All consecutive patients with rectal cancer in the period 2002-2008 were included. Data were gathered on survival, tumour stage, co-morbidity score, and cause of death. The patients were divided in three groups: group 1 patients undergoing surgery without neo-adjuvant radiotherapy; group 2 patients undergoing radiotherapy followed by immediate surgery; and group 3 patients treated with (chemo) radiotherapy followed by a longer waiting period.Results: A total of 113 patients with rectal cancer underwent surgery. Twenty two patients in group 1, 71 patients in group 2, and 20 in group 3. There was no difference in gender, time to recurrence, co-morbidity score, or causes of death. Fifty percent of patients died due to non-cancer related causes. Mean age in patients of group 3 was significantly lower than in groups 1 and 2 (P=0.02). There was a trend towards a lower tumour stage in the patients of group 3. Overall five year survival was 32% in group 1, 48% in group 2, and 35% in group 3.Conclusions: Neo-adjuvant radiotherapy seems to be of benefit in daily practice in patients with rectal cancer. A longer waiting period results in down-staging. Clinicians have to be aware that many patients will die due to other causes than those related to the rectal cancer.

Tumor stage in patients operated for rectal cancer: a comparison of the pre-operative MR and the resection specimen, with specific attention to the effect of neo-adjuvant radiotherapy

“…Whether a long or short waiting period after radiotherapy is necessary still is a matter of debate (11,12). In the cohort diagnosed and treated in the Zaans Medisch Centrum, a longer waiting period results in a better outcome (13).…”

Systematic review of exercise training in colorectal cancer patients during treatment

“…As patients with rectal cancer receive neoadjuvant treatment in the period between diagnosis and surgery, there is ample time for physical training. This relatively long time frame can support the optimization of functional capacity in individual patients, thus allowing for improved recovery …”

The Impact of Surgical Techniques in Patients with Rectal Cancer on Spine Mobility and Abdominal Muscle Strength—A Prospective Study

“…Our study showed no statistical differences for theresults of total spine flexion, inhalation–exhalation difference and rectus abdominis muscle strength in terms of neoadjuvant or adjuvant treatment. Other studies haveshownthe influence of peri- and postopertive treatment onfunctional capacity [ 33 , 34 ], but spinal mobililty, inhalation–exhalation difference and rectus abdominis muscle strength had not been measured yet.…”