title: Evaluation of safety of increased time interval between chemoradiation and resection for rectal cancer.
abstract: BACKGROUND
  Neoadjuvant chemoradiation is increasingly used for rectal cancer, with resection typically performed 6 weeks after completion of radiotherapy. We observed in our practice that further delay after radiotherapy led to increased downsizing. We performed this retrospective analysis to evaluate the safety of this approach.
  
  
  METHODS
  A retrospective review was performed of 48 patients with distal or mid-rectal cancer who were operated on 8 weeks or less after chemoradiation ended (group 1, n = 16), and more than 8 weeks later (group 2, n = 32). We looked at the effect of delaying surgery on intraoperative blood loss, operative and hospital duration, postoperative complications, readmissions, and mortality.
  
  
  RESULTS
  The median interval between radiation and operation was 7 weeks in group 1 and 11 weeks in group 2. There was no significant difference between the 2 groups in terms of intraoperative blood loss, postoperative complications, or readmissions. Length of operation and length of stay were slightly longer for group 2.
  
  
  CONCLUSIONS
  Delaying surgery after neoadjuvant treatment appears safe, with morbidity and mortality similar to that seen with surgery performed less than 8 weeks after chemoradiation.
authors.affiliation: Division of Colon and Rectal Surgery, University of California, Irvine, Medical Center, 101 The City Drive South, Building 55, Suite 110, Irvine, CA, USA.
authors.forename: Cam-Ly
authors.initials: CL
authors.lastname: Tran
authors.forename: Sejal
authors.initials: S
authors.lastname: Udani
authors.forename: Alicia
authors.initials: A
authors.lastname: Holt
authors.forename: Tracey
authors.initials: T
authors.lastname: Arnell
authors.forename: Ravin
authors.initials: R
authors.lastname: Kumar
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011878:Radiotherapy; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents