ORIGINAL ARTICLE   

Minerva Surgery 2022 June;77(3):245-51

DOI: 10.23736/S2724-5691.21.08770-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Time interval between neoadjuvant radio-chemotherapy and surgery in rectal cancer: is the long interval correct for all patients?

Antonio COSTANZO ¹, Antonio GHIDINI ² ✉, Fausto PETRELLI ³, Luca TURATI ¹, Valentina RAMPULLA ¹, Antonio VARRICCHIO ¹, Arianna TRIZZINO ¹, Alfio A. RUSSO ¹, Giovanni SGROI ¹

¹ Unit of Surgical Oncology, ASST Bergamo Ovest, Treviglio, Bergamo, Italy; ² Medical Oncology, Casa di Cura Igea, Milan, Italy; ³ Unit of Oncology, Department of Medical Sciences, ASST Bergamo Ovest, Treviglio, Bergamo, Italy

BACKGROUND: Optimal time between neoadjuvant radio-chemotherapy period and surgery remains controversial in patients with rectal cancer: an increasing number of studies show results in favor of a long interval.
METHODS: We conducted a retrospective analysis of the cases of low-middle rectal adenocarcinoma undergoing neoadjuvant RT-CT and surgery: the primary endpoint was the complete pathological response rate and the secondary endpoint the rate of complications. We analyzed cases from 1/01/2003 to 31/12/2018 divided in two periods: from 2003 to 2010 (23 pts) and from 2011 to 2018 (23 pts). The two periods were characterized by two different surgical teams which use different time intervals (≤ vs. >8 weeks).
RESULTS: The pCR rate is 21.7% in both groups; as regards the complications, the difference between the two groups is in grade IIIb: 8.7% in the first group and 17.4% in the second group (P=0.66).
CONCLUSIONS: Although our study is based on a small number of patients, it shows the same rate of pCR with respect to two different time intervals; this suggests the need for studies based on the division of patients into subgroups and the evaluation of different time intervals in order to reach the best oncological outcomes.

KEY WORDS: Rectal neoplasms; Neoadjuvant therapy; Radiotherapy; Drug therapy; Surgical procedures, operative