Dr Liu on Surgical Outcomes Following Radiation and Chemotherapy in Rectal Cancer

I-Chia (Daniel) Liu, MD, resident, Radiation Oncology, Johns Hopkins Medicine, discusses findings from a retrospective analysis of surgical and local control outcomes following sequential short-course radiation therapy and chemotherapy for rectal cancer, highlighting the significance of these findings.

At the 2024 ACRO Summit, Liu and investigators presented data from a retrospective review, which showed that prolonged duration from neoadjuvant SCRT to surgery did not increase the risk of poor mesorectum specimen quality or postoperative morbidity in patients with rectal cancer. 

Based on the outcomes of the study, investigators noted that the timeframe between the cessation of radiation therapy and the surgical intervention did not exert any discernible influence on the quality of the surgical specimens, Liu begins. The focus of this research primarily centered on evaluating the integrity of mesorectal specimens, a parameter widely acknowledged for its significance in ensuring effective oncological control, as evidenced by previous studies, he says. Investigators discovered that even in instances with a prolonged interval between radiation and surgery, the surgical team still managed to achieve thorough and complete mesorectal specimens, Liu notes. 

Regarding the management protocols for locally advanced rectal cancer, SCRT continues to offer considerable benefits, particularly in terms of bolstering control over distant disease progression, he continues. Nevertheless, it is imperative to remain cognizant of these findings and explore avenues for refinement, such as potential dose-escalation strategies aimed at more effectively targeting pelvic lymph nodes that may be closely implicated, Liu adds.

Crucially, this research underscores that the duration between the conclusion of radiation therapy and the commencement of surgery does not bear any significant correlation with the occurrence of surgical complications or the pathological outcomes thereof, he continues. As such, investigators advocate for the continued consideration of this approach as a viable treatment option for patients seeking optimal rectal cancer management, aligned with individual preferences and circumstances, Liu concludes.