Literature DB >> 20177689

Neoadjuvant chemoradiotherapy, sepsis and neutrophil levels following radical excision of rectal cancer.

Aneel Bhangu1, Peter Nightingale, Darren Daniels, Raju Tiramula.   

Abstract

PURPOSE: This study aimed to determine differences in neutrophil levels between those receiving long-course neoadjuvant chemoradiotherapy (nCXRT) and those proceeding straight to surgery (StS) for rectal cancer, and in those who developed serious septic events within 30 post-operative days within each group.
METHOD: Patients undergoing elective surgery between 2006 and 2008 were retrospective reviewed. Some 38 received nCXRT, and 46 proceeded StS. Statistical techniques included repeated measures analyses.
RESULTS: There was no significant difference in serious 30-day septic rates (anastomotic leaks, pelvic abscess or generalised sepsis) between treatment groups (nCXRT, 11%; StS, 13%; p = 1.000). Neutrophil levels in the nCXRT group fell significantly and remained lower throughout treatment than those proceeding StS (p < 0.001 within groups, p < 0.001 between groups). The difference in means of the treatment groups was different for those with sepsis than for those without, and the difference in means of those with sepsis and those without is very different for the two treatment groups (p = 0.018).
CONCLUSION: Chemoradiotherapy reduced neutrophil levels throughout treatment, and post-operative septic patients in this group had even lower levels. Further studies are warranted to fully assess the relationship of neutrophil levels to sepsis, using standardised definitions of sepsis.

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Mesh:

Year:  2010        PMID: 20177689     DOI: 10.1007/s00384-010-0886-9

Source DB:  PubMed          Journal:  Int J Colorectal Dis        ISSN: 0179-1958            Impact factor:   2.571


  25 in total

1.  Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer.

Authors:  E Kapiteijn; C A Marijnen; I D Nagtegaal; H Putter; W H Steup; T Wiggers; H J Rutten; L Pahlman; B Glimelius; J H van Krieken; J W Leer; C J van de Velde
Journal:  N Engl J Med       Date:  2001-08-30       Impact factor: 91.245

2.  Risk factors for anastomotic leakage after rectal cancer surgery: a case-control study.

Authors:  P Jestin; L Påhlman; U Gunnarsson
Journal:  Colorectal Dis       Date:  2008-03-03       Impact factor: 3.788

3.  Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery.

Authors:  Sang Hun Jung; Chang Sik Yu; Pyong Wha Choi; Dae Dong Kim; In Ja Park; Hee Cheol Kim; Jin Cheon Kim
Journal:  Dis Colon Rectum       Date:  2008-04-12       Impact factor: 4.585

4.  Improved survival with preoperative radiotherapy in resectable rectal cancer.

Authors:  B Cedermark; M Dahlberg; B Glimelius; L Påhlman; L E Rutqvist; N Wilking
Journal:  N Engl J Med       Date:  1997-04-03       Impact factor: 91.245

5.  Risk factors for anastomotic leakage after preoperative chemoradiation therapy and low anterior resection with total mesorectal excision for locally advanced rectal cancer.

Authors:  Saúl E Rodríguez-Ramírez; Arizbeth Uribe; Erika Betzabé Ruiz-García; Sonia Labastida; Pedro Luna-Pérez
Journal:  Rev Invest Clin       Date:  2006 May-Jun       Impact factor: 1.451

6.  Risk factors for anastomotic failure after total mesorectal excision of rectal cancer.

Authors:  K C M J Peeters; R A E M Tollenaar; C A M Marijnen; E Klein Kranenbarg; W H Steup; T Wiggers; H J Rutten; C J H van de Velde
Journal:  Br J Surg       Date:  2005-02       Impact factor: 6.939

7.  Neoadjuvant therapy and anastomotic leak after tumor-specific mesorectal excision for rectal cancer.

Authors:  Guillaume Martel; Youssuf Al-Suhaibani; Husein Moloo; Fatima Haggar; Martin Friedlich; Joseph Mamazza; Eric C Poulin; Hartley Stern; Robin P Boushey
Journal:  Dis Colon Rectum       Date:  2008-06-04       Impact factor: 4.585

8.  Impaired postoperative neutrophil leucocytosis and acute complications following short course preoperative radiotherapy for operable rectal cancer.

Authors:  A Hartley; S Giridharan; N Srihari; C McConkey; J I Geh
Journal:  Eur J Surg Oncol       Date:  2003-03       Impact factor: 4.424

Review 9.  Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review.

Authors:  Nicole M Kuderer; David C Dale; Jeffrey Crawford; Gary H Lyman
Journal:  J Clin Oncol       Date:  2007-07-20       Impact factor: 44.544

Review 10.  Prophylactic antibiotics or G-CSF for the prevention of infections and improvement of survival in cancer patients undergoing chemotherapy.

Authors:  Christine Herbst; Frauke Naumann; Eva-Brigitta Kruse; Ina Monsef; Julia Bohlius; Holger Schulz; Andreas Engert
Journal:  Cochrane Database Syst Rev       Date:  2009-01-21
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  1 in total

1.  Effects of Neoadjuvant Radiotherapy on Postoperative Complications in Rectal Cancer: A Meta-Analysis.

Authors:  Jianguo Yang; Yajun Luo; Tingting Tian; Peng Dong; Zhongxue Fu
Journal:  J Oncol       Date:  2022-01-05       Impact factor: 4.375

  1 in total

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