Published online Aug 21, 2020. doi: 10.3748/wjg.v26.i31.4624
Peer-review started: May 26, 2020
First decision: June 4, 2020
Revised: June 7, 2020
Accepted: August 1, 2020
Article in press: August 1, 2020
Published online: August 21, 2020
Surgery with total mesorectal excision following neoadjuvant therapy is a standard regime for locally advanced rectal cancer. The optimal interval time between neoadjuvant therapy and surgery is still under debate.
There is a lack of consensus concerning the interval time between neoadjuvant therapy and surgery. Whether shorter or longer interval time is a controversial topic. And there are limited data regarding outcomes associated with different neoadjuvant therapy-surgery times.
The main aim of this study was to investigate whether different interval times affect the rate of pathologic complete response (pCR), preoperative outcomes, and survival status.
We performed a retrospective cohort study and enrolled locally advanced rectal cancer patients with neoadjuvant therapy. Information regarding the clinicopathological features, clinical outcomes, and follow-up was collected and analyzed. Multivariate logistic regression analysis was performed to evaluate the possible factor affected by interval time.
The interval time between neoadjuvant therapy and surgery > 9 wk increased the incidence of pCR and had a better impact on disease-free survival (DFS).
Prolonging the interval time between neoadjuvant therapy and surgery may be associated with improved rates of pCR, decreased disease recurrence, and improved DFS but has little impact on postoperative complications and sphincter preservation.
Prospective randomized trials are required to evaluate the optimal time interval that is needed to achieve minimum morbidity, maximal tumor downstaging, and minimum disease recurrence.