Original CommunicationDoes pathologic response of rectal cancer influence postoperative morbidity after neoadjuvant radiochemotherapy and total mesorectal excision?
Section snippets
Patient selection
From 2006 to 2011, all consecutive patients (n = 210) who underwent elective rectal resection with total mesorectal excision for rectal cancer were identified from a prospectively maintained colorectal service database at Beaujon Hospital, Paris, France. The rectal cancer was preoperatively staged according to the TNM (ie, tumor, nodes, metastasis) classification with the use of an endorectal ultrasound, abdominopelvic computed tomography (CT) scanning, and more recently pelvic magnetic
Results
A total of 143 patients (median age of 61 years [29−84], male to female ratio: 89:54) were included for the analysis. Patients' characteristics are detailed on Table I. The median distance of the lower edge of the rectal tumor from the dentate line was 35 mm (0−85). The majority of the patients were found to have a T3 disease (n = 117, 82%) and a lymph node involvement (n = 110, 77%) on the initial staging investigations. Median CRT-to-surgery time interval was 8 weeks (range, 5−12).
Discussion
This study was designed to assess the potential relationship between the tumor response after neoadjuvant CRT and the postoperative complications. We showed that the rates of severe morbidity (ie, Dindo ≥3), clinical AL, and overall infection-related complications were less for patients in the pCR group compared with the non-pCR group. To our knowledge, very few data are available about the impact of pCR on the postoperative morbidity. This study is first to report a lower risk of laparoscopic
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