Background
For advanced rectal cancer, neoadjuvant radiochemotherapy has been proven to reduce the rate of local recurrence in comparison to postoperative treatment. German guidelines state exact treatment rules for UICC stage I to III and localization of cancer in the rectum. The decision for a neoadjuvant treatment is based on local staging. Since there has been no impact of neoadjuvant treatment on cancer related survival or distant metastases, effort was taken to improve the systemic results of the neoadjuvant radiochemotherapy (RCT). By adding a second drug to the neoadjuvant radiochemotherapy, the rate of complete responses and tumor regression grade could be increased. A complete response has been shown to be a predictive marker for disease free and cancer related survival. Thus, an intensified neoadjuvant RCT protocol was introduced at several institutions including irinotecan or oxaliplatin.
A potential increase of perioperative morbidity following an intensified radiochemotherapy has not been reported so far.
The aim of this study was to investigate, whether an intensified neoadjuvant radiochemotherapy leads to an increase of perioperative surgical morbidity.