Effectiveness Of Neoadjuvant Therapy On Locally Advanced Rectal Cancer And Its Impact On The Post-operative Complications

PURPOSE:To investigate the effect of neoadjuvant therapy on locally advanced rectal cancer and the impact on postoperative complications with different regimes of patients with advanced rectal cancer.METHODS:Retrospectively analyze the post-data of 83 hospitalized local advanced rectal cancer cases from Shanghai Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine during 1st,January,2016 and 31st,January,2019.60 cases were included in neoadjuvant radiochemotherapy(NCRT)group and the other 23 were included in Neoadjuvant chemotherapy(NCT)group.RESULTS:Of all the neoadjuvant therapy cases,48(57.8%)had retraction at the lower edge of the tumor,with a median retraction distance of 1.0 cm.A total of 41 cases(49.4%)had the deterioration of post-operative anatomic stage,49 cases(59.0%)had the deterioration of post-operative T stage,and 55 cases(66.3%)had the deterioration of postoperative N stage.After treatment,14 cases(16.9%)were evaluated as CR(Complete Response)and 16 cases(19.3%)as TRG-0 in pathology after operation.Except for the reduction rate of T stage(P<0.05),there was no difference in the efficacy of other treatments(N downstaging,anatomic downstaging)between NRCT group and NCT group(P>0.05).The operation time of NRCT group was significantly longer than that of NCT group(P<0.05),but there was no difference in the R0 rate,conversion rate,bleeding volume during operation,proportion of primary stoma,fluids diet opening time,hospitalization days between NRCT group and NCT group(P>0.05).There was no difference in the incidence of anastomotic leakage,anastomotic bleeding,anastomotic stenosis,incision infection and stoma complications between the two groups(P>0.05).CONCLUSION:Neoadjuvant therapy can receive tumor downstaging preoperatively or even get complete remission,thus ensures R0 resection rate of locally advanced rectal cancer.Both groups had tumor downstaging effect,while NRCT group had a better Tstaging reduction rate than NCT group implying the effectiveness of local control of NRCT,and there was no difference in the incidence of postoperative complications between the two groups.