Berkel, A.E.M. (Annefleur) (2013) Postoperatieve morbiditeit en tumorregressie na neoadjuvante chemoradiatie gevolgd door rectumresectie bij locally advanced rectumcarcinoom. thesis, Medicine.
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Abstract
Background: In patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by rectal resection, postoperative morbidity is a significant clinical problem. Pathologic complete tumour response seems to be associated with the best prognosis in the long-term. Little is known about the factors that are associated with postoperative complications and pathologic complete response. Aim of this retrospective study was to identify and describe these factors. Methods: 99 consecutive patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation (50 Gy and capecitabine) followed by surgery at Medisch Spectrum Twente between 01-2007 and 05-2012 were identified. Postoperative complications (within 6 months) were graded according to the Clavien-Dindo classification. Pathologic tumour response was categorized as complete response or no/partial response. Results: Postoperative complications occurred in 68 patients (69%) and grade 3-5 complications in 25 patients (25%). The 30-day mortality was 1% (n=1) and the 90-day mortality was 2% (n=2). A lower mean age (p=0.02) and a pre- or postoperative blood transfusion (p<0.01) independently predicted complications. Blood transfusion (p=0.01) and ypT0-1 stage (p=0.04) were independent predictors of grade 3-5 complications. Complete response rate was 22% (n=22). There were no independent clinical factors predicting complete response. Conclusions: Neoadjuvant chemoradiation followed by rectal surgery is associated with a significant postoperative complication rate, but minimal postoperative mortality. A complete response rate of 22% can be achieved.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Klaase, Dr. J. M. chirurg-oncoloog and Locatie: Medisch Spectrum Twente, chirurgie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:44 |
| Last Modified: | 25 Jun 2020 10:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/558 |
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