Prognostic Factors for Postoperative Morbidity and Tumour Response After Neoadjuvant Chemoradiation Followed by Resection for Rectal Cancer

Annefleur E.M. Berkel, Dankert P. Woutersen, Jacobus Adrianus Maria van der Palen, Joost M. Klaase

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Abstract

Background and Purpose. In patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by rectal resection, postoperative morbidity is a significant clinical problem. Pathologic complete tumour response seems to give the best prognosis in the long term. Little is known about the factors that are associated with postoperative complications and pathologic complete response. The aim of this retrospective study was to identify and describe these factors. Methods Ninety-nine consecutive patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation (50 Gy and capecitabine) followed by surgery at our institute between January 2007 andMay 2012 were identified. Postoperative complications were graded according to the Clavien-Dindo classification. Pathologic tumour response was categorized as complete response or no/partial response. Results Postoperative complications occurred in 68 patients (69 %) and grade 3–5 complications in 25 patients (25 %). The 30-day and 90-day mortality were 1 % (n=1) and 2 % (n=2), respectively. A young age (p=0.021) and a preoperative or postoperative blood transfusion (p=0.015) independently predicted complications. Intraoperative or postoperative blood transfusion (p=0.007) and ypT0-1 stage (p=0.037) were independent predictors for grade 3–5 complications. Complete response rate was 22 % (n=22); 4%(n=4) of patients showed no response. No independent factors predicting complete response were found. Conclusions Neoadjuvant chemoradiation followed by rectal resection is associated with significant postoperative morbidity but minimal postoperative mortality. A complete response rate of 22 % was achieved.
Original languageEnglish
Pages (from-to)1648-1657
JournalJournal of gastrointestinal surgery
Volume18
Issue number9
DOIs
Publication statusPublished - 2014

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Rectal Neoplasms
Morbidity
Neoplasms
Blood Transfusion
Mortality
Retrospective Studies

Keywords

  • IR-91884
  • METIS-305179

Cite this

@article{dc46f9c7db354648bb1321078fdee9e6,
title = "Prognostic Factors for Postoperative Morbidity and Tumour Response After Neoadjuvant Chemoradiation Followed by Resection for Rectal Cancer",
abstract = "Background and Purpose. In patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by rectal resection, postoperative morbidity is a significant clinical problem. Pathologic complete tumour response seems to give the best prognosis in the long term. Little is known about the factors that are associated with postoperative complications and pathologic complete response. The aim of this retrospective study was to identify and describe these factors. Methods Ninety-nine consecutive patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation (50 Gy and capecitabine) followed by surgery at our institute between January 2007 andMay 2012 were identified. Postoperative complications were graded according to the Clavien-Dindo classification. Pathologic tumour response was categorized as complete response or no/partial response. Results Postoperative complications occurred in 68 patients (69 {\%}) and grade 3–5 complications in 25 patients (25 {\%}). The 30-day and 90-day mortality were 1 {\%} (n=1) and 2 {\%} (n=2), respectively. A young age (p=0.021) and a preoperative or postoperative blood transfusion (p=0.015) independently predicted complications. Intraoperative or postoperative blood transfusion (p=0.007) and ypT0-1 stage (p=0.037) were independent predictors for grade 3–5 complications. Complete response rate was 22 {\%} (n=22); 4{\%}(n=4) of patients showed no response. No independent factors predicting complete response were found. Conclusions Neoadjuvant chemoradiation followed by rectal resection is associated with significant postoperative morbidity but minimal postoperative mortality. A complete response rate of 22 {\%} was achieved.",
keywords = "IR-91884, METIS-305179",
author = "Berkel, {Annefleur E.M.} and Woutersen, {Dankert P.} and {van der Palen}, {Jacobus Adrianus Maria} and Klaase, {Joost M.}",
year = "2014",
doi = "10.1007/s11605-014-2559-4",
language = "English",
volume = "18",
pages = "1648--1657",
journal = "Journal of gastrointestinal surgery",
issn = "1091-255X",
publisher = "Springer",
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}

Prognostic Factors for Postoperative Morbidity and Tumour Response After Neoadjuvant Chemoradiation Followed by Resection for Rectal Cancer. / Berkel, Annefleur E.M.; Woutersen, Dankert P.; van der Palen, Jacobus Adrianus Maria; Klaase, Joost M.

In: Journal of gastrointestinal surgery, Vol. 18, No. 9, 2014, p. 1648-1657.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Prognostic Factors for Postoperative Morbidity and Tumour Response After Neoadjuvant Chemoradiation Followed by Resection for Rectal Cancer

AU - Berkel, Annefleur E.M.

AU - Woutersen, Dankert P.

AU - van der Palen, Jacobus Adrianus Maria

AU - Klaase, Joost M.

PY - 2014

Y1 - 2014

N2 - Background and Purpose. In patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by rectal resection, postoperative morbidity is a significant clinical problem. Pathologic complete tumour response seems to give the best prognosis in the long term. Little is known about the factors that are associated with postoperative complications and pathologic complete response. The aim of this retrospective study was to identify and describe these factors. Methods Ninety-nine consecutive patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation (50 Gy and capecitabine) followed by surgery at our institute between January 2007 andMay 2012 were identified. Postoperative complications were graded according to the Clavien-Dindo classification. Pathologic tumour response was categorized as complete response or no/partial response. Results Postoperative complications occurred in 68 patients (69 %) and grade 3–5 complications in 25 patients (25 %). The 30-day and 90-day mortality were 1 % (n=1) and 2 % (n=2), respectively. A young age (p=0.021) and a preoperative or postoperative blood transfusion (p=0.015) independently predicted complications. Intraoperative or postoperative blood transfusion (p=0.007) and ypT0-1 stage (p=0.037) were independent predictors for grade 3–5 complications. Complete response rate was 22 % (n=22); 4%(n=4) of patients showed no response. No independent factors predicting complete response were found. Conclusions Neoadjuvant chemoradiation followed by rectal resection is associated with significant postoperative morbidity but minimal postoperative mortality. A complete response rate of 22 % was achieved.

AB - Background and Purpose. In patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by rectal resection, postoperative morbidity is a significant clinical problem. Pathologic complete tumour response seems to give the best prognosis in the long term. Little is known about the factors that are associated with postoperative complications and pathologic complete response. The aim of this retrospective study was to identify and describe these factors. Methods Ninety-nine consecutive patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation (50 Gy and capecitabine) followed by surgery at our institute between January 2007 andMay 2012 were identified. Postoperative complications were graded according to the Clavien-Dindo classification. Pathologic tumour response was categorized as complete response or no/partial response. Results Postoperative complications occurred in 68 patients (69 %) and grade 3–5 complications in 25 patients (25 %). The 30-day and 90-day mortality were 1 % (n=1) and 2 % (n=2), respectively. A young age (p=0.021) and a preoperative or postoperative blood transfusion (p=0.015) independently predicted complications. Intraoperative or postoperative blood transfusion (p=0.007) and ypT0-1 stage (p=0.037) were independent predictors for grade 3–5 complications. Complete response rate was 22 % (n=22); 4%(n=4) of patients showed no response. No independent factors predicting complete response were found. Conclusions Neoadjuvant chemoradiation followed by rectal resection is associated with significant postoperative morbidity but minimal postoperative mortality. A complete response rate of 22 % was achieved.

KW - IR-91884

KW - METIS-305179

U2 - 10.1007/s11605-014-2559-4

DO - 10.1007/s11605-014-2559-4

M3 - Article

VL - 18

SP - 1648

EP - 1657

JO - Journal of gastrointestinal surgery

JF - Journal of gastrointestinal surgery

SN - 1091-255X

IS - 9

ER -