Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy

Background: The impact of neoadjuvant treatment and their subsequent early complications in the treatment of rectal cancer has not been adequately assessed. The aim of this prospective study was to evaluate early postoperative morbidity and mortality among patients with rectal cancer treated with ad...

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Autores: Valenti-Azcarate, V. (Víctor)|||/items/43ffa5b1-000e-4670-8fa2-4ab80d1960d7, Hernandez-Lizoain, J.L. (Jose Luis)|||/items/57a38c27-cc3f-4081-866c-d2287fccaac2, Baixauli-Fons, J. (Jorge)|||/items/c863985d-f450-4807-a4fe-56d26f6e8dfa, Pastor-Idoate, C. (Carlos)|||/items/db004f1c-c96b-428d-b929-408dda2c568d, Aristu-Mendioroz, J.J. (José Javier)|||/items/324b9db0-23f7-40e4-a8fa-7d27e66b099a, Diaz-Gonzalez, J.A. (Juan Antonio)|||/items/3f4fb669-f3ec-4e28-bc61-3278443cfecf, Beunza, J.J. (Juan José)|||/items/e99e8796-30cd-4126-97f5-b304222ec38c, Álvarez-Cienfuegos, J. (Javier)|||/items/88871d37-0dae-4312-a6d8-0596bc69158c
Tipo de recurso: artículo
Fecha de publicación:2007
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/22718
Acceso en línea:https://hdl.handle.net/10171/22718
Access Level:acceso abierto
Palabra clave:Rectal cancer
Chemoradiation
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spelling Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant ChemoradiotherapyValenti-Azcarate, V. (Víctor)|||/items/43ffa5b1-000e-4670-8fa2-4ab80d1960d7Hernandez-Lizoain, J.L. (Jose Luis)|||/items/57a38c27-cc3f-4081-866c-d2287fccaac2Baixauli-Fons, J. (Jorge)|||/items/c863985d-f450-4807-a4fe-56d26f6e8dfaPastor-Idoate, C. (Carlos)|||/items/db004f1c-c96b-428d-b929-408dda2c568dAristu-Mendioroz, J.J. (José Javier)|||/items/324b9db0-23f7-40e4-a8fa-7d27e66b099aDiaz-Gonzalez, J.A. (Juan Antonio)|||/items/3f4fb669-f3ec-4e28-bc61-3278443cfecfBeunza, J.J. (Juan José)|||/items/e99e8796-30cd-4126-97f5-b304222ec38cÁlvarez-Cienfuegos, J. (Javier)|||/items/88871d37-0dae-4312-a6d8-0596bc69158cRectal cancerChemoradiationBackground: The impact of neoadjuvant treatment and their subsequent early complications in the treatment of rectal cancer has not been adequately assessed. The aim of this prospective study was to evaluate early postoperative morbidity and mortality among patients with rectal cancer treated with adjuvant radiotherapy and chemotherapy followed by surgery, compared with patients treated with surgery alone. We also identified independent risk factors associated with early major complications. Methods: Between 1995 and 2004, 273 consecutive patients underwent treatment for rectal cancer. A total of 170 patients (group A) received preoperative radiotherapy with a total of 45–50.4 Gy (180 cGy per day) and 5-fluorouracil-based chemotherapy, followed by surgery; 103 patients (group B) were treated with surgery alone. Dependent variables related to patients, treatment, radiotherapy, and tumor were analyzed. Results: Both groups were similar with regard to age, sex, body mass index, American Society of Anesthesiologists (ASA) score, and tumor location but not for ileostomy (27% in group A vs. 6.8% in group B). The number of complications was similar in both groups (43.1% in group A vs. 44.6% in group B). No differences in wound infection (8.2% vs. 7.8%), intraabdominal abscess (4.7% vs. 4.9%), anastomotic dehiscence (4.2% vs. 3.8%), postoperative hemorrhage (3.5% vs. 3.9%), urinary complications (6.5% vs. 4.9%), paralytic ileus (8.9% vs. 9.7%), or general complications (7.1% vs. 9.6%) were found. The global mortality in the first 30 days after surgery was .7%. An ASA score of III–IV and surgery duration longer than 3 hours were identified as independent prognostic factors for early complications. Conclusions: Preoperative chemoradiation in patients with rectal cancer treated with surgery is not associated with a higher incidence of early postoperative complications. The patient~s preoperative clinical condition and lengthy surgery time are prognostic factors for early complications.Lippincott, Williams & WilkinsDadun. Depósito Académico Digital Universidad de Navarra20122012-06-2720072007-01-0120072007-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/22718reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dadun.unav.edu:10171/227182026-06-21T12:47:57Z
dc.title.none.fl_str_mv Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy
title Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy
spellingShingle Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy
Valenti-Azcarate, V. (Víctor)|||/items/43ffa5b1-000e-4670-8fa2-4ab80d1960d7
Rectal cancer
Chemoradiation
title_short Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy
title_full Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy
title_fullStr Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy
title_full_unstemmed Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy
title_sort Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy
dc.creator.none.fl_str_mv Valenti-Azcarate, V. (Víctor)|||/items/43ffa5b1-000e-4670-8fa2-4ab80d1960d7
Hernandez-Lizoain, J.L. (Jose Luis)|||/items/57a38c27-cc3f-4081-866c-d2287fccaac2
Baixauli-Fons, J. (Jorge)|||/items/c863985d-f450-4807-a4fe-56d26f6e8dfa
Pastor-Idoate, C. (Carlos)|||/items/db004f1c-c96b-428d-b929-408dda2c568d
Aristu-Mendioroz, J.J. (José Javier)|||/items/324b9db0-23f7-40e4-a8fa-7d27e66b099a
Diaz-Gonzalez, J.A. (Juan Antonio)|||/items/3f4fb669-f3ec-4e28-bc61-3278443cfecf
Beunza, J.J. (Juan José)|||/items/e99e8796-30cd-4126-97f5-b304222ec38c
Álvarez-Cienfuegos, J. (Javier)|||/items/88871d37-0dae-4312-a6d8-0596bc69158c
author Valenti-Azcarate, V. (Víctor)|||/items/43ffa5b1-000e-4670-8fa2-4ab80d1960d7
author_facet Valenti-Azcarate, V. (Víctor)|||/items/43ffa5b1-000e-4670-8fa2-4ab80d1960d7
Hernandez-Lizoain, J.L. (Jose Luis)|||/items/57a38c27-cc3f-4081-866c-d2287fccaac2
Baixauli-Fons, J. (Jorge)|||/items/c863985d-f450-4807-a4fe-56d26f6e8dfa
Pastor-Idoate, C. (Carlos)|||/items/db004f1c-c96b-428d-b929-408dda2c568d
Aristu-Mendioroz, J.J. (José Javier)|||/items/324b9db0-23f7-40e4-a8fa-7d27e66b099a
Diaz-Gonzalez, J.A. (Juan Antonio)|||/items/3f4fb669-f3ec-4e28-bc61-3278443cfecf
Beunza, J.J. (Juan José)|||/items/e99e8796-30cd-4126-97f5-b304222ec38c
Álvarez-Cienfuegos, J. (Javier)|||/items/88871d37-0dae-4312-a6d8-0596bc69158c
author_role author
author2 Hernandez-Lizoain, J.L. (Jose Luis)|||/items/57a38c27-cc3f-4081-866c-d2287fccaac2
Baixauli-Fons, J. (Jorge)|||/items/c863985d-f450-4807-a4fe-56d26f6e8dfa
Pastor-Idoate, C. (Carlos)|||/items/db004f1c-c96b-428d-b929-408dda2c568d
Aristu-Mendioroz, J.J. (José Javier)|||/items/324b9db0-23f7-40e4-a8fa-7d27e66b099a
Diaz-Gonzalez, J.A. (Juan Antonio)|||/items/3f4fb669-f3ec-4e28-bc61-3278443cfecf
Beunza, J.J. (Juan José)|||/items/e99e8796-30cd-4126-97f5-b304222ec38c
Álvarez-Cienfuegos, J. (Javier)|||/items/88871d37-0dae-4312-a6d8-0596bc69158c
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Dadun. Depósito Académico Digital Universidad de Navarra
dc.subject.none.fl_str_mv Rectal cancer
Chemoradiation
topic Rectal cancer
Chemoradiation
description Background: The impact of neoadjuvant treatment and their subsequent early complications in the treatment of rectal cancer has not been adequately assessed. The aim of this prospective study was to evaluate early postoperative morbidity and mortality among patients with rectal cancer treated with adjuvant radiotherapy and chemotherapy followed by surgery, compared with patients treated with surgery alone. We also identified independent risk factors associated with early major complications. Methods: Between 1995 and 2004, 273 consecutive patients underwent treatment for rectal cancer. A total of 170 patients (group A) received preoperative radiotherapy with a total of 45–50.4 Gy (180 cGy per day) and 5-fluorouracil-based chemotherapy, followed by surgery; 103 patients (group B) were treated with surgery alone. Dependent variables related to patients, treatment, radiotherapy, and tumor were analyzed. Results: Both groups were similar with regard to age, sex, body mass index, American Society of Anesthesiologists (ASA) score, and tumor location but not for ileostomy (27% in group A vs. 6.8% in group B). The number of complications was similar in both groups (43.1% in group A vs. 44.6% in group B). No differences in wound infection (8.2% vs. 7.8%), intraabdominal abscess (4.7% vs. 4.9%), anastomotic dehiscence (4.2% vs. 3.8%), postoperative hemorrhage (3.5% vs. 3.9%), urinary complications (6.5% vs. 4.9%), paralytic ileus (8.9% vs. 9.7%), or general complications (7.1% vs. 9.6%) were found. The global mortality in the first 30 days after surgery was .7%. An ASA score of III–IV and surgery duration longer than 3 hours were identified as independent prognostic factors for early complications. Conclusions: Preoperative chemoradiation in patients with rectal cancer treated with surgery is not associated with a higher incidence of early postoperative complications. The patient~s preoperative clinical condition and lengthy surgery time are prognostic factors for early complications.
publishDate 2007
dc.date.none.fl_str_mv 2007
2007-01-01
2007
2007-01-01
2012
2012-06-27
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10171/22718
url https://hdl.handle.net/10171/22718
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Lippincott, Williams & Wilkins
publisher.none.fl_str_mv Lippincott, Williams & Wilkins
dc.source.none.fl_str_mv reponame:Dadun. Depósito Académico Digital de la Universidad de Navarra
instname:Universidad de Navarra
instname_str Universidad de Navarra
reponame_str Dadun. Depósito Académico Digital de la Universidad de Navarra
collection Dadun. Depósito Académico Digital de la Universidad de Navarra
repository.name.fl_str_mv
repository.mail.fl_str_mv
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