Neutrocyte count variations duringpreoperative short course radiotherapy in rectal cancer cT3NxM0 patients subjected to restorative resections - their influence on long term survival and postoperative morbidity: P092


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Abstract

Aim:None.Method:Between December 2001 and March 2003 116 patients with cT3NxM0 rectal cancer were treated withpreoperative 5 × 5 G radiotherapy in whom resection withprimary anastomosis was performed. All patients had blood morphology sampledprior to radiotherapy, after the radiotherapy andprior to surgery and within 24 hours following surgery.Results:Analysis of the results indicates that there are two distinctive patterns of neutrocyte number responses as a result of radiotherapy. The first group (A), as expected, experiences a reduction in absolute neutrocyte count (N = 79), but in 37 patients there was increase in number of neutrocytes observed (B). The number of postoperative complications was higher in group B than in A (46.6% vs 26.6%, P < 0.001), as well as the number of anastomotic leaks (18.9% vs 11.3%). Additionally, this group experienced inferior 5-year cancer specific survival (73.2% vs 89.9%, P < 0.01). The multiparametric Cox analysis for survival indicated that the independant variables for survival in this group were neutrocyte count following radiotherapy, % change in neutrocyte count following radiotherapy,presence of anastomotic leaks andpresence of nodal involvement.Conclusion:Patients with increased neutrocyte count followingpreoperative 5 × 5 G radiotherapy in resectable rectal cancer should be re-evaluated for response in larger clinical trials.

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