title: Postoperative morbidity following chemoradiation for locally advanced low rectal cancer.
abstract: BACKGROUND
  Postoperative morbidity remains a significant clinical problem and may alter long-term outcome particularly after neoadjuvant chemoradiation in patients with locally advanced low rectal cancer. The aim of the present study was to identify a potential long-term effect of postoperative morbidity.
  
  
  METHODS
  Analysis of prospectively collected data of 90 consecutive patients who underwent neoadjuvant chemoradiation and curative mesorectal excision for locally advanced (cT3/4, Nx, M0/1) adenocarcinoma of the mid and lower third of the rectum during a 7-year period (1996-2002).
  
  
  RESULTS
  Major postoperative complications occurred in 17.8% and minor complications in 26.6% of patients. Hospital mortality and 30-day mortality was 0%. Infectious complications were seen in 34.5%. The leading causes of infectious complications were anastomotic leakage and perineal wound infection. Postoperative morbidity was statistically significantly associated with gender (P < 0.05), pre-therapeutic haemoglobin level (P < 0.05), ASA score (P < 0.05), hospitalisation (P < 0.001) and clinical long-time course (P < 0.01). Moreover, early postoperative morbidity was proven as an independent prognostic factor concerning disease-free (P < 0.05) and overall survival (P < 0.05).
  
  
  CONCLUSIONS
  Early postoperative morbidity in patients with preoperative chemoradiation due to locally advanced low rectal cancer is demonstrated as an independent prognosticator. Gender, pre-therapeutic haemoglobin level and ASA score indicate patients at risk for early postoperative complications and may therefore serve as predictive features.
authors.affiliation: Department of Visceral, Transplant, and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Stelzmueller
authors.forename: Matthias
authors.initials: M
authors.lastname: Zitt
authors.forename: Felix
authors.initials: F
authors.lastname: Aigner
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kafka-Ritsch
authors.forename: Robert
authors.initials: R
authors.lastname: Jäger
authors.forename: Alexander
authors.initials: A
authors.lastname: De Vries
authors.forename: Peter
authors.initials: P
authors.lastname: Lukas
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Eisterer
authors.forename: Hugo
authors.initials: H
authors.lastname: Bonatti
authors.forename: Dietmar
authors.initials: D
authors.lastname: Ofner
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003141:Communicable Diseases / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D012307:Risk Factors; D016019:Survival Analysis