Title

Contemporary, national patterns of surgery after preoperative therapy for stage II/III rectal adenocarcinoma.

Document Type

Article

Publication Date

6-15-2022

Publication Title

World J Gastrointest Oncol

Keywords

oregon; chiles

Abstract

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.

Clinical Institute

Cancer

Clinical Institute

Digestive Health

Department

Oncology

Department

Gastroenterology

Department

Surgery

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