- Patients with locally advanced rectal cancer who wait >8 weeks between chemoradiotherapy (CRT) and total mesorectal excision (TME) have higher rates of pathological complete response (pCR) and better disease regression than those who undergo surgery ≤8 weeks.
Why this matters
- Previous studies on the association between wait times between CRT and resection yielded conflicting results.
- Phase 3, randomized, parallel-group controlled trial.
- 327 patients with locally advanced rectal cancer underwent surgery ≤8 weeks after CRT (classical interval [CI] group; n=160) or >8 weeks after CRT (long interval [LI] group; n=167).
- Funding: None disclosed.
- pCR rate higher in LI group (18.6% vs 10.0%; P=.027).
- Best pCR rates were achieved in the LI group, at intervals of 10-11 weeks (71-77 days; 29% of patients) and 9-10 weeks (64-70 days; 22% of patients).
- LI group had significantly greater disease regression, with better stage (P=.004) and T category (P=.001).
- No significant difference between groups in R0 resection, TME quality, rates of grade 3 mesorectal-plane surgery, or mortality.
- Morbidity rate was lower in LI group (19.8% vs 22.5%; P=.307).
- Single-center study.