Short-term Outcomes Of Rectal Cancer Treated With Radical Surgery After Long Or Short Course Neoadjuvant Radiotherapy

Objective: To explore the short-term efficacy of neoadjuvant therapy on locall y advanced mid-lower rectal cancer patients and evaluate the feasibility and safet y of radicalresectionafterneoadjuvant therapy.Methods: A retrospective analysis was performed on 135 cases of locally adv anced mid-lower rectal cancer patients, who were received radical surgery in our hospital during from January 2013 to January 2016. According to the treatment methods of different preoperative treatment modality, the cases could divided into three groups: long-course preoperative radiochemotherapy group(n=36),short-course preoperative radiotherapy group(n=37) and the simple operation group(n=62).For long-course preoperative radiochemotherapy group, the radical surgery was perfor med 6-8 weeks after preoperative radiochemotherapy.For short-course preoperative radiotherapygroup,the radical surgery was performed 1 week after preoperative r adiochemotherapy. And in the simple operation group, the patients were accepted operation directly. All the patients were implemented radical surgery,which was based on the principle of total mesorectum excision(TME). The tumor patholog ic regression was observed and explored between long-course preoperative radioc hemotherapy group and short-course preoperative radiotherapy group after neoadju vant therapy. Meanwhile, surgical parameters, postoperative recovery and incidenc e of postoperative complications among the three groups were also compared by utilizing the SPSS.Results:The different tumor pathologic regression after neoadjuvant therapy was observed between long-course preoperative radiochemotherapy group and short-co urse preoperative radiotherapy group, T downstage rate(47.2%vs24.3%,P=0.041),pathologic complete response rate(13.9%vs0%,P=0.025),the discrepancies were st atistical significance;N downstage to negative rate(40.7%vs34.8%,P=0.773),the discrepancies showed no statistical significance. The medianof resected lymphnode s in three groups was 14?18 and 19 respectively,the median of resected lymph nodes in long-course preoperative radiochemotherapy group was significantlylowe r than other two groups(P<0.01). The median of resected lymph nodes in Short-c ourse preoperative radiotherapy group and simple operation groupshowed nostatist ical significance(P>0.05). While the differences in other surgical parameters and postoperative recovery variables as well as the incidence of postoperative compli cations between the three groups showed no statistical significance(all P>0.05).Conclusion:Preoperative neoadjuvant therapy for locally advanced mid-lower r ectal cancer patients was short-term significantly, tow group patients were tumorp athologic downstaging even pathologic complete response after neoadjuvant therap y, neoadjuvant therapy does not increaseoperative difficulty and postoperative co mplications. Radical resection is safe and feasible in patients with locally advanc ed mid-low rectal cancer after neoadjuvant therapy.Compared to short-course preo perative radiotherapy group, long-course preoperative radiochemotherapy group ha s advantages on T downstage rate and pathologic complete response rate, needslo ng-term follow-up and further study to assess their long-term curative effect discr epancy.