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Oncological outcomes of direct versus delayed surgery after neoadjuvant short-course radiotherapy for rectal cancer: national cohort study
By Azhar N, Lydrup ML and Buchwald P.
Abstract
Background
After the Stockholm III trial, a trend towards delayed surgery after neoadjuvant short-course radiotherapy (5 × 5 Gy) for rectal cancer has emerged in Sweden, driven by the lower short-term complication rates and similar oncological outcomes. This study aimed to examine long-term oncological outcomes after neoadjuvant short-course radiotherapy, comparing direct versus delayed surgery for rectal cancer in a real-world setting.
Methods
A registry-based retrospective national cohort study was conducted using prospectively collected data from the Swedish Colorectal Cancer Registry. Patients with rectal cancer receiving neoadjuvant neoadjuvant short-course radiotherapy with surgery between 2016 and 2020 were analysed for oncological outcomes (local recurrence, distant metastasis) and overall survival at 3 years, comparing direct surgery, defined as surgery within 7 days after neoadjuvant short-course radiotherapy, and delayed surgery, defined as surgery after 28-90 days. The rate of patients who underwent surgery within the delayed time frame of the Stockholm III trial was also recorded.