Impact of neoadjuvant chemoradiation therapy on the postoperative complication rate in rectal cancer

Abstract

Purpose: The impact of neoadjuvant chemoradiation therapy (CRT) on the postoperative complication rate is discussed controversially. Thus the aim of this study was to evaluate the postoperative complication rate in our patient population. Methods: A retrospective analysis was performed to examine all patients documented online who had undergone conventionally fractionated adjuvant or neoadjuvant CRT from 2001 to 2009 in conjunction with curative resection (R0) for sporadic primary colorectal cancer in the middle or lower third. A total of 246 patients were included and analyzed. Two groups were formed: Group I, 2001-2004, adjuvant CRT, n108, and Group II, 2005-2009, neoadjuvant CRT, n138. Results: The two groups had comparable patient-, tumorand therapyrelated characteristics. No difference was found in the anastomotic leak rate (Group I vs. II: 10% vs. 11%). The rate of perineal wound healing problems differed significantly (Group I vs. II: 5% vs. 36%, p0.016). While no patient died in Group I, lethality amounted to 1.5% (2/138) in Group II. Conclusions: Neoadjuvant CRT does not lead to a higher anastomotic leak rate or lethality in comparison to patients who were primarily operated and received adjuvant CRT in the further course. The rate of perineal wound healing problems is significantly increased.