Tran Cam-Ly, Udani Sejal, Holt Alicia, Arnell Tracey, Kumar Ravin, Stamos Michael J
Division of Colon and Rectal Surgery, University of California, Irvine, Medical Center, 101 The City Drive South, Building 55, Suite 110, Irvine, CA, USA.
Am J Surg. 2006 Dec;192(6):873-7. doi: 10.1016/j.amjsurg.2006.08.061.
Neoadjuvant chemoradiation is increasingly used for rectal cancer, with resection typically performed 6 weeks after completion of radiotherapy. We observed in our practice that further delay after radiotherapy led to increased downsizing. We performed this retrospective analysis to evaluate the safety of this approach.
A retrospective review was performed of 48 patients with distal or mid-rectal cancer who were operated on 8 weeks or less after chemoradiation ended (group 1, n = 16), and more than 8 weeks later (group 2, n = 32). We looked at the effect of delaying surgery on intraoperative blood loss, operative and hospital duration, postoperative complications, readmissions, and mortality.
The median interval between radiation and operation was 7 weeks in group 1 and 11 weeks in group 2. There was no significant difference between the 2 groups in terms of intraoperative blood loss, postoperative complications, or readmissions. Length of operation and length of stay were slightly longer for group 2.
Delaying surgery after neoadjuvant treatment appears safe, with morbidity and mortality similar to that seen with surgery performed less than 8 weeks after chemoradiation.
新辅助放化疗越来越多地用于直肠癌治疗，通常在放疗结束后6周进行手术切除。我们在临床实践中观察到，放疗后进一步延迟会导致肿瘤降期增加。我们进行了这项回顾性分析以评估这种方法的安全性。
对48例远端或中段直肠癌患者进行回顾性研究，这些患者在放化疗结束后8周或更短时间内接受手术（第1组，n = 16），以及在8周后接受手术（第2组，n = 32）。我们观察了延迟手术对术中失血、手术时间和住院时间、术后并发症、再次入院率和死亡率的影响。
第1组放疗与手术之间的中位间隔时间为7周，第2组为11周。两组在术中失血、术后并发症或再次入院率方面无显著差异。第2组的手术时间和住院时间略长。
新辅助治疗后延迟手术似乎是安全的，其发病率和死亡率与放化疗后不到8周进行手术的情况相似。
