TU Shengjin 1,2 , ZHANG Wendi 1,3 , LIU Jianbo 1 , YIN Jin 1,4 , WANG Xiaodong 1 , LI Li 5 , YANG Lie 1
  • 1. Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 2. Department of General Surgery, Fourth People’s Hospital of Zigong, Zigong, Sichuan 643000, P. R. China;
  • 3. West China Clinical Medical College of Sichuan University, Chengdu 610041, P. R. China;
  • 4. Institute of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 5. Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
WANG Xiaodong, Email: wangxiaodong@wchscu.cn
rectal cancer; neoadjuvant therapy; intersphincteric resection; long-term outcome; complication; anal preservation
10.7507/1007-9424.202404058
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Objective Based on the latest version of the Database from Colorectal Cancer(DACCA), this study analyzed the long-term effect of neoadjuvant therapy combined with intersphincteric resection (ISR) in patients with rectal cancer. Methods According to the established screening criteria, clinical data of 944 patients with rectal cancer admitted from January 2009 to December 2020 were collected from the DACCA updated on March 21, 2022, to explore the influencing factors for overall survival (OS) and disease specific survival (DSS) of rectal cancer treated with neoadjuvant therapy combined with ISR, by Cox proportional hazard regression model. Results ① The 3-year OS and DSS survival rates of neoadjuvant therapy combined with ISR for rectal cancer were 89.2% and 90.4%, respectively, and the 5-year OS and DSS survival rates were 83.9% and 85.4%, respectively. ② For different ISR surgical methods and neoadjuvant therapy plans, there were no significant differences in OS and DSS (P>0.05), but there were significant differences in OS and DSS among different ypTNM stage groups (P<0.001), patients with ypTNM 0–Ⅱ had better OS and DSS. ③ BMI, ypTNM stage and R0 resection were influencing factors for OS and DSS (P<0.05). ④ The overall incidence of postoperative complications was low, including 6.4% (60/944) within 30 days, 7.5% (71/944) within half a year and 3.3% (31/944) over half a year after operation. Conclusions In the comprehensive treatment of patients with low/ultra-low rectal cancer, neoadjuvant therapy combined with ISR can achieve relatively stable and good long-term oncological efficacy, and the incidence of short-term postoperative complications is not high, which is one of the options.