Outcomes of Preoperative versus Postoperative Chemoradio-therapy for Locally Advanced Rectal Cancer

Abstract

Aim. To investigate the patients’ outcomes of preoperative chemoradiotherapy (CRT) versus postop-erative CRT for locally advanced rectal cancer. Patients and Methods. Clinicopathological variables of 124 patients with locally advanced rectal cancer treated with CRT preoperatively (81 patients) or postoperatively (43 patients) from 2010 to 2017 was investigated retrospectively. Results. There was no significant differences of patients’ characteristics between two groups. Through follow-up duration 52 months (range, 7-116 months), 24 patients (34.6%) in the preoperative CRT group and 28 patients (55.8%) in the postoperative CRT group had died. The 5-year overall survival rate was 65.3% and 34.7% for the preoperative and postoperative CRT group, respectively (p = 0.010). The 5-year disease free survival rate was 85.3% and 53.5% for the preoperative and postoperative CRT group, respectively (p = 0.007). Pathologic tumor and nodal down-staging observed after the preoperative CRT with sta-tistically significance (p <0.0001 and p <0.0001, respectively). Postoperative CRT group had higher ratio of adverse events than preoperative CRT (46.5 % and 21%, respectively). Conclusion. In patients with locally advanced rectally cancer, preoperative CRT could be advantageous for improving overall survival, disease free survival, tumour regression rate and to reduce adverse events.