Determining the optimal radiation-surgery interval (RSI) for oncologic proctectomy following radiotherapy for rectal adenocarcinoma

J Surg Oncol. 2023 Jun;127(8):1252-1258. doi: 10.1002/jso.27273.

Abstract

Preoperative radiotherapy has improved outcomes in rectal cancer patients, however, the optimal interval between radiation and proctectomy is unknown. A review of contemporary literature suggests an 8-12 week interval between radiation and surgery likely improves tumor response rates for rectal cancer patients undergoing proctectomy, which may convey modest improvements in long-term oncologic outcomes. Prolonged radiation-surgery intervals may expose surgeons to pelvic fibrosis, however, which may impact later-term proctectomies and compromise perioperative and oncologic outcomes.

Keywords: adenocarcinoma/radiotherapy; adenocarcinoma/surgery; rectal neoplasms/radiotherapy; rectal neoplasms/surgery.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma* / pathology
  • Adenocarcinoma* / radiotherapy
  • Adenocarcinoma* / surgery
  • Humans
  • Neoadjuvant Therapy / adverse effects
  • Neoplasm Staging
  • Proctectomy*
  • Rectal Neoplasms* / pathology
  • Rectal Neoplasms* / radiotherapy
  • Rectal Neoplasms* / surgery
  • Retrospective Studies
  • Treatment Outcome