Details

Autor(en) / Beteiligte

• Buie, Donald W
• MacLean, Anthony R
• Attard, Jo-Anne P
• Brasher, Penelope M. A
• Chan, Alexander K

Titel

Neoadjuvant Chemoradiation Increases the Risk of Pelvic Sepsis After Radical Excision of Rectal Cancer

Ist Teil von

• Diseases of the colon & rectum, 2005-10, Vol.48 (10), p.1868-1874

Ort / Verlag

Secaucus, NJ: The ASCRS

Erscheinungsjahr

2005

Quelle

MEDLINE

Beschreibungen/Notizen

• PURPOSE: METHODS: RESULTS:From January 1994 to December 2002, 246 patients (151 males; mean age 68 (range, 36-97) years) underwent curative resection for rectal cancer. Procedures included 186 anterior resections, 52 abdominoperineal resections, and 8 Hartmann's. Of 60 patients (24.4 percent) who had neoadjuvant chemoradiation, 9 (15 percent) developed pelvic sepsis (3 leaks, 6 abscesses) compared with 9 of 186 (4.8 percent) after primary surgery (6 leaks, 3 abscesses; P < 0.01). Ninety-three patients had an anastomosis ≤6 cm from the anal verge. Of these, 9 patients (9.7 percent) developed pelvic sepsis (5 leaks, 4 abscesses)5 of 28 (17.9 percent) after neoadjuvant chemoradiation vs. 4 of 65 (6.2 percent) after primary surgery (P = 0.22). Only 6 of 93 patients (6.5 percent) with an anastomosis ≥7 cm developed pelvic sepsis (5 leaks and 1 abscess), of whom 1 had preoperative radiation. Pelvic abscess developed in 3 of 24 patients after neoadjuvant chemotherapy and abdominoperineal resection. After primary abdominoperineal resection, none of the remaining 28 patients developed pelvic sepsis. A multivariable logistic regression model was constructed to determine predictors of sepsis. Neoadjuvant chemotherapy was the only variable that was predictive (odds ratio, 3.4; 95 percent confidence interval, 1.3-9). CONCLUSIONS: