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24.08.2023 | original article

Unraveling the impact of interval length between neoadjuvant chemoradiotherapy and surgery on perioperative and postoperative complications in rectal cancer patients

verfasst von: Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Abkhoo, Alireza Kazemeini, Seyed Mohsen Ahmadi Tafti, Mohammad Reza Keramati, Amirhosein Naseri, Amir Keshvari

Erschienen in: European Surgery | Ausgabe 5-6/2023

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Summary

Background

The optimal timing for surgery following neoadjuvant chemoradiotherapy (nCRT) in rectal cancer patients and its impact on perioperative and postoperative complications remain subjects of debate. This retrospective study aimed to investigate the association between the interval between nCRT and surgery and postoperative complications.

Methods

Data from 279 patients who underwent nCRT were analyzed. The relationship between interval length and peri- and postoperative complications was assessed using the Mann–Whitney test and Spearman’s rank correlation. Logistic regression was employed to evaluate the predictive value of the interval length for outcomes, adjusting for clinicopathological characteristics. Receiver operating characteristic (ROC) analysis determined the optimal cut-off value.

Results

The median interval between nCRT and surgery was 14 weeks (range 4 to 63 weeks). The length of the interval was associated with mean operative time and length of hospital stay (β = −0.86 and 0.03; p = 0.008 and 0.047; respectively). However, no significant associations were found between the interval length and peri- or postoperative complications in uni- or multivariate analyses. ROC analysis demonstrated significant results for total complications, ileus/bowel obstruction, and stomal necrosis (area under the curve [AUC] = 0.58, 0.71, and 0.67; p = 0.045, 0.002, and 0.001; respectively) and identified cut-off values of less than 12, 15, and 12 weeks, respectively, for minimizing these complications.

Conclusion

A longer interval between nCRT and surgery in rectal cancer patients was associated with shorter operative times but longer hospital stays. No significant association was found between time intervals and complications, except for total complications, ileus/bowel obstruction, and stomal necrosis. Timely surgical intervention is crucial for optimizing outcomes.
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Metadaten
Titel
Unraveling the impact of interval length between neoadjuvant chemoradiotherapy and surgery on perioperative and postoperative complications in rectal cancer patients
verfasst von
Behnam Behboudi
Mohammad Sadegh Fazeli
Alireza Abkhoo
Alireza Kazemeini
Seyed Mohsen Ahmadi Tafti
Mohammad Reza Keramati
Amirhosein Naseri
Amir Keshvari
Publikationsdatum
24.08.2023
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5-6/2023
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-023-00809-8