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Time Interval Between Radiotherapy and Surgery Does Not Affect Outcomes in Rectal Cancer
*Yasmeen Z. Qwaider, *Naomi M. Sell, *Robert N. Goldstone, *Christy E. Cauley, Rocco Ricciardi, Liliana G. Bordeianou, Hiroko Kunitake, David L. Berger
Massachusetts General Hospital, Boston, MA

Objective: To study the effect of the time interval between the end of radiotherapy and surgical resection on outcomes in rectal cancer.Design: Cohort study with mean follow-up duration 50 months.Setting: Tertiary medical institutionPatients: All consecutive patients (n=250) who underwent neoadjuvant radiotherapy and resection for rectal cancer between 2004 and 2015, excluding those who underwent short-course radiotherapy (≤1 week).Interventions: N/A
Main Outcome Measures: Postoperative outcomes (anastomotic leak, pathologic complete response [pCR], readmission), overall survival and disease-free survival.Results: 250 patients (62% male) underwent resection with a median time interval of 8 weeks (range: 4-92 weeks) from completion of radiotherapy. On multivariable logistic regression, there was no significant association between time interval to surgery and anastomotic leak (aOR=0.9 [0.7-1.1], p=0.3), pCR (aOR=0.9[0.7-1.2] p=0.4), intraoperative complications (aOR=1.03 [1.0-1.07], p = 0.07), or readmission (aOR=1 [0.9-1.04] p=0.7). In addition, time interval to surgery was not an independent prognostic factor for overall survival (aHR=0.98 [0.93-1.03]; p=0.5) or disease-free-survival (HR=0.98 [0.96-1.02], p=0.5).Conclusions: The time interval between the completion of neoadjuvant radiotherapy and surgical resection does not affect anastomotic leak rate, achievement of pCR, or overall and disease-free survival in patients with rectal cancer.


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