Rectal Cancer Surgery Best at 56 Days Post Chemotherapy, Radiation

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Best length of time to wait to perform surgery for rectal cancer after chemotherapy and radiation treatment.
Best length of time to wait to perform surgery for rectal cancer after chemotherapy and radiation treatment.

Researchers say they've pinpointed the best length of time to wait to perform surgery for rectal cancer after chemotherapy and radiation treatment have been completed. The findings were published in the Journal of the American College of Surgeons.

The researchers examined outcomes among 11,760 U.S. patients with stage II or III localized rectal cancer who had combined chemoradiotherapy and surgery between 2006 and 2012. The time between chemoradiotherapy and surgery ranged from 43 to 63 days.

Patients who had surgery precisely eight weeks (56 days) after they completed chemoradiotherapy had the best survival rates and successful removal of their tumors. Waiting any longer may increase the risk of tumor regrowth, the researchers found.

Compared to those who had surgery within 55 days of chemoradiotherapy, those who had surgery at or after 56 days were slightly older (59 versus 58 years of age) and more likely to be black (9.5 versus 8.0 percent).

In addition, they were more likely to be treated at an academic hospital, less likely to have private insurance, and more likely to have stage III cancer.

"In the global picture, there's a lot of discussion about if waiting longer for surgery is better, and if you don't wait as long there's less chance of tumor spreading, but none of it is backed up on good modeling data like we have in this study," study leader Christopher Mantyh, M.D., of Duke University in Durham, N.C., said in a news release from the American College of Surgeons.

Reference

  1. Sun Z, Adam MA, Kim J, et al. Optimal Timing to Surgery After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer. Journal of the American College of Surgeons. [published online ahead of print January 20, 2016]. DOI: http://dx.doi.org/10.1016/j.jamcollsurg.2015.12.017.

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