In a nutshell
This trial was carried out to examine the optimal time interval between completing chemoradiotherapy (CRT) and robotic-assisted surgery (RAS) in patients with rectal cancer. The trial found that RAS is safe and effective after 10-12 weeks of CRT.
Some background
Rectal cancer treatment has experienced an improvement with new medical and surgical approaches. The standard surgical approach has been total mesorectal excision (TME) where a large portion of the bowel surrounding the tumor is removed. CRT is commonly carried out before surgery to decrease the size of tumors and improve outcomes of patients with rectal cancer.
RAS is a type of minimally invasive surgery that uses robotic arms to remove the tumor. RAS offers significant advantages such as decreased infection risk and improved surgeon-precision. Previous studies have shown that a minimum of 10-12 weeks after CRT are needed for successful rectal cancer surgery. However, there have been no studies evaluating the ideal time interval between completing CRT and undergoing RAS.
Methods & findings
There were 116 patients in this trial. 98 patients had middle and lower rectal cancers. All patients had CRT and RAS after 10 weeks or more. 57 patients had RAS within 10-12 weeks after CRT (group 1). 59 patients had RAS after 12 weeks or more from CRT (group 2). The average follow-up for both groups was 30 months.
A total of 24 patients experienced a relapse. Relapse was slightly more common in group 2 (28.8%) compared to group 1 (15.8%).
Disease-free survival after 3 years was 80% in group 1 compared to 71% in group 2. Overall survival at 3 years was 92% in group 1 compared to 87% in group 2. However, these differences were not statistically significant. There was no difference in complications following surgery between groups.
The bottom line
The authors concluded that RAS is safe for patients with rectal cancer and can be performed at 10-12 weeks after CRT.
The fine print
This study was based on medical records. Information might have been missing.
Published By :
PLOS ONE
Date :
Oct 17, 2020