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Optimal waiting period to surgical treatment after neoadjuvant chemoradiotherapy for locally advanced rectum cancer: A retrospective observational study

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dc.contributor.authorATICI, ALİ EMRE
dc.contributor.authorBOZKURTLAR, EMİNE
dc.contributor.authorYEGEN, ŞEVKET CUMHUR
dc.contributor.authorsAslanov K., ATICI A. E., Karaman D., BOZKURTLAR E., YEGEN Ş. C.
dc.date.accessioned2023-06-05T11:05:41Z
dc.date.available2023-06-05T11:05:41Z
dc.date.issued2023-12-01
dc.description.abstractBackground: The optimal waiting period after neoadjuvant treatment in patients with locally advanced rectal cancers is still controversial. The literature has different results regarding the effect of waiting periods on clinical and oncological outcomes. We aimed to investigate the effects of these different waiting periods on clinical, pathological, and oncological outcomes. Methods: Between January 2014 and December 2018, a total of 139 consecutive patients with locally advanced rectal adenocarcinoma, who were treated in the Department of General Surgery at the Marmara University Pendik Training and Research Hospital, were enrolled in the study. The patients were split into three groups according to waiting time for surgery after neoadjuvant treatment: group 1 (n = 51) included patients that have 7 weeks and less (≤ 7 weeks) time interval, group 2 (n = 45) 8 to 10 weeks (8–10 weeks), group 3 (n = 43) 11 weeks and above (11 weeks ≤). Their database records, which were entered prospectively, were analyzed retrospectively. Results: There were 83 (59.7%) males and 56 (40.3%) females. The median age was 60 years, and there was no statistical difference between the groups regarding age, gender, BMI, ASA score, ECOG performance score, tumor location, and preoperative CEA values. Also, we found no significant differences regarding operation times, intraoperative bleeding, length of hospital stay, and postoperative complications. According to the Clavien–Dindo (CD) classification, severe early postoperative complications (CD 3 and above) were observed in 9 patients. The complete pathological response (pCR, ypT0N0) was observed in 21 (15.1%) patients. The groups had no significant difference regarding 3-year disease-free and 3-year overall survival (p = 0.3, p = 0.8, respectively). Local recurrence was observed in 12 of 139 (8.6%) patients and distant metastases occurred in 30 of 139 (21.5%) patients during the follow-up period. There was no significant difference between the groups in terms of both local recurrence and distant metastasis (p = 0.98, p = 0.43, respectively). Conclusion: The optimal time for postoperative complications and sphincter-preserving surgery in patients with locally advanced rectal cancer is 8–10 weeks. The different waiting periods do not affect disease-free and overall survival. While long-term waiting time does not make a difference in pathological complete response rates, it negatively affects the TME quality rate.
dc.identifier.citationAslanov K., ATICI A. E., Karaman D., BOZKURTLAR E., YEGEN Ş. C., "Optimal waiting period to surgical treatment after neoadjuvant chemoradiotherapy for locally advanced rectum cancer: a retrospective observational study", Langenbeck's Archives of Surgery, cilt.408, sa.1, 2023
dc.identifier.doi10.1007/s00423-023-02930-4
dc.identifier.issn1435-2443
dc.identifier.issue1
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85160247819&origin=inward
dc.identifier.urihttps://hdl.handle.net/11424/289939
dc.identifier.volume408
dc.language.isoeng
dc.relation.ispartofLangenbeck's Archives of Surgery
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectTıp
dc.subjectCerrahi Tıp Bilimleri
dc.subjectSağlık Bilimleri
dc.subjectMedicine
dc.subjectSurgery Medicine Sciences
dc.subjectHealth Sciences
dc.subjectKlinik Tıp (MED)
dc.subjectKlinik Tıp
dc.subjectCERRAHİ
dc.subjectClinical Medicine (MED)
dc.subjectCLINICAL MEDICINE
dc.subjectSURGERY
dc.subjectCerrahi
dc.subjectSurgery
dc.subjectInterval
dc.subjectLocally advanced rectal cancer
dc.subjectNeoadjuvant chemoradiotherapy
dc.subjectWaiting period
dc.subjectLocally advanced rectal cancer
dc.subjectNeoadjuvant chemoradiotherapy
dc.subjectWaiting period
dc.subjectInterval
dc.titleOptimal waiting period to surgical treatment after neoadjuvant chemoradiotherapy for locally advanced rectum cancer: A retrospective observational study
dc.typearticle
dspace.entity.typePublication
local.avesis.id73604237-1818-465c-a523-292bcfbb3b7c
local.indexed.atPUBMED
local.indexed.atSCOPUS
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relation.isAuthorOfPublication2343a71e-12cf-42ea-89ed-b222d121f733
relation.isAuthorOfPublicationa459a57f-37f4-4d95-9491-1ed272a299cf
relation.isAuthorOfPublication.latestForDiscoveryf73441d4-7381-49ad-99af-fe877618e6e1

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