gms | German Medical Science

Introduction: 5-year survival in rectal cancer is dependent on the occurrence of a local recurrence. It can be influenced on the one hand by exact adherence to surgical oncology practces, on the other hand by additional therapeutic regimes such as a combination of radiotherapy and systemic chemotherapy. Aside from timing, procedure of additional therapy and interval between radio-chemotherapy and surgical intervention, the following question question (issue) is in discussion: does neoadjuvant chemotherapy increase the rate of intra-surgical complications.

Material and methods: Experience is based a total of 20 patients: 11 patients participating in the Erlangen trial (combination of 5-FU and radiation), 6 patients enrolled in a Xeloda phase-II-trial and 3 patients from a pilot trial with oxaliplatin and Xeloda.

Results: All patients were judged as non-resectable based on an intensive pre-operative diagnostic regimen. Following neoadjuvant radio-chemotherapy, all patients could be treated surgically by TME-resection or amputation. Interventions were conducted by two surgeons. Intraoperative complications, which could be attributed to the neoadjuvant radio-chemotherapy, were not experienced in any of the patients. Pre-tumorous inflammation and tumor had regressed in all cases.

Conclusions: Intra-operative complications occurrred in none of the patients. Based on our experience, neoadjuvant radio-chemotherapy in its various modifictions does not constitute a hindrance for a radical surgical treatment.