The following is a summary of “Word of caution: Rectal cancer without response to neoadjuvant treatment – Do not wait for surgery,” published in the October 2023 issue of Surgery by Duraes, et al.
For a study, researchers sought to explore the potential impact of extending the interval to surgery in individuals exhibiting poor tumor response to neoadjuvant chemoradiation therapy (nCRT) in rectal adenocarcinoma cases.
Patients with rectal adenocarcinoma characterized by inadequate tumor response to nCRT (AJCC tumor regression grade 3) were specifically included in the study. The primary focus was on assessing oncologic outcomes concerning the duration between the completion of nCRT and the surgical intervention.
Among the 56 non-responsive patients, those who underwent surgery ≥8 weeks post the conclusion of nCRT demonstrated notably inferior disease-free survival (31% vs. 49%, P = 0.05) and overall survival (34% vs. 53%, P = 0.02) compared to patients with a shorter interval (<8 weeks). Employing different time intervals (≥12 weeks, 6–12 weeks, and <6 weeks), consistently, longer waiting periods were associated with deteriorated overall survival (23% vs. 48% vs. 63%, P = 0.02) and compromised cancer-specific survival (35% vs. 61% vs. 71%, P = 0.04), respectively.
The findings suggested that delaying surgery in rectal cancer patients displaying non-responsiveness to nCRT may lead to unfavorable oncologic outcomes. It underscored the importance of considering optimal timing for surgery in a particular subset of patients to mitigate potential negative impacts on survival and disease-free intervals.
Source: americanjournalofsurgery.com/article/S0002-9610(23)00124-1/fulltext
