Contemporary, national patterns of surgery after preoperative therapy for stage II/III rectal adenocarcinoma.
World J Gastrointest Oncol
BACKGROUND: Contemporary treatment of stage II/III rectal cancer combines chemotherapy, chemoradiation, and surgery, though the sequence of surgery with neoadjuvant treatments and benefits of minimally-invasive surgery (MIS) is debated.
AIM: To describe patterns of surgical approach for stage II/III rectal cancer in relation to neoadjuvant therapies.
METHODS: A retrospective cohort was created using the National Cancer Database. Primary outcome was rate of sphincter-sparing surgery after neoadjuvant therapy. Secondary outcomes were surgical approach (open, laparoscopic, or robotic), surgical quality (R0 resection and 12+ lymph nodes), and overall survival.
RESULTS: A total of 38927 patients with clinical stage II or III rectal adenocarcinoma underwent surgical resection from 2010-2016. Clinical stage II patients had neoadjuvant chemoradiation less frequently compared to stage III (75.8%
CONCLUSION: Sphincter preservation rates are similar across stage II and III rectal cancer, regardless of delivery of preoperative chemotherapy, chemoradiation, or both. At a national level, there is a shift to predominantly MIS approaches for rectal cancer, regardless of whether sphincter sparing procedure is performed.
Soriano, Celine; Bahnson, Henry T; Kaplan, Jennifer A; Lin, Bruce; Moonka, Ravi; Pham, Huong T; Kennecke, Hagen F; and Simianu, Vlad, "Contemporary, national patterns of surgery after preoperative therapy for stage II/III rectal adenocarcinoma." (2022). Articles, Abstracts, and Reports. 6457.