Impact Of Interval Between Preoperative Chemotherapy And Surgery On â…¢A And â…¢Bî–¨Rectal Cancer

Objective:This study aims to assess whether the time interval between neoadjuvant chemoradiotherapy and surgery affects the pathologic complete response (pCR) rate, disease-free survival (DFS),,The local recurrence rate,RO(Endoscopic resection margin no residual cancer) resection rate and overall survival (OS) in ⅢA and ⅢB rectal cancer.Methtods:We retrospectively studied 93 ⅢA and ⅢB rectal cancer patients diagnosed by pathological examination who underwent neoadjuvant therapy followed by total mesorectal excision (TME) between March 2009 and March 2011 in our hospital. Patients were divided into two groups according to the interval between neoadjuvant therapy and surgery:Group A (≤7 wk, n=49) and Group B (>7 wk, n= 44). The primary endpoint, reported as pCR rate, DFS, disease recurrence,R0 resection rate and OS. Secondary endpoints were type of surgery, postoperative complications, operation time and length of hospital stay. Results:The pCR rate was 18.3% (pCR:group A vs group B,8.2% vs 29.5%; P= 0.008),and 3-year DFS was 39.8% (DFS:group A vs group B,28.6% vs 52.3%; P= 0.013). Disease recurrence was 20.4% in group A versus 4.5% in group B (P= 0.023),R0 resection rate(group A vs group B,85.7% vs 97.7%; P= 0.039). There were no significant differences in OS, type of surgery, postoperative complications, operation time and length of hospital stay between two groups. Conclusion:A neoadjuvant-surgery interval >7 wk increases the rate of pCR and DFS and decreases disease recurrence in Ⅲ A and ⅢB rectal cancer, may improve the patient’s R0 resection rate,with no effect on type of surgery, postoperative complications, operation time, length of hospital stay and oncologic outcome.