Impaired postoperative neutrophil leucocytosis and acute complications following short course preoperative radiotherapy for operable rectal cancer.
OBJECTIVE
Postoperative mortality following total mesorectal excision is increased if this is performed more than 3 days after the completion of short course preoperative radiotherapy. Suppression of neutrophil leucocytosis which is normally seen following surgery has been a suggested reason. This study was to determine the relationship between postoperative complications and perioperative neutrophil counts.


METHODS
A database of 176 patients treated at a single radiotherapy centre in 1998 and 1999 was used. A two-sample Wilcoxon test was used to compare preoperative neutrophil counts, postoperative neutrophil counts and their ratio in patients with and without complications.


RESULTS
There was no association between acute complications and preoperative (P = 0.25) or postoperative (P = 0.45) neutrophil count. The post/preoperative ratio was significantly higher in patients without complications (median 1.61 vs 1.16, P = 0.02).


CONCLUSIONS
There appears to be an inverse relationship between the magnitude of postoperative neutrophil leucocytosis and the risk of acute complications following short course preoperative radiotherapy.
Hartley
A
A
Cancer Centre, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK. agjhartley.fsnet.co.uk
Giridharan
S
S
Srihari
N
N
McConkey
C
C
Geh
J I
JI
D000208:Acute Disease; D003131:Combined Modality Therapy; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000209:etiology*; D009504:Neutrophils; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000097:blood / Q000532:radiotherapy* / Q000601:surgery; D012307:Risk Factors