Impact of preoperative transcatheter rectal arterial chemoembolization with concurrent chemoradiotherapy on surgery and prognosis of patients with locally advanced rectal cancer

• Published in: Journal of surgical oncology Vol. 124; no. 8; pp. 1451 - 1458
• Main Authors: Meng, Wenjun, Yang, Bo, Huang, Bin, Chen, Chuan, Zhu, Jianwu, Jian, Dan, Zhong, Li, Wang, Dong, Li, Chunxue, Bai, Lian
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc 01-12-2021
• Subjects: Chemoembolization; Chemotherapy; Colorectal cancer; locally advanced rectal cancer; Metastasis; neoadjuvant therapy; operative security; Radiation therapy; short‐term outcome; Surgery; transcatheter rectal arterial chemoembolization
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.26673

Background and Objectives
To analyze and evaluate the impact of preoperative transcatheter rectal arterial chemoembolization (TRACE) with concurrent chemoradiotherapy on surgery and prognosis of locally advanced rectal cancer (LARC).
Methods
A total of 118 patients with LARC were enrolled in this nonrandomized prospective study. They were assigned into the experimental group receiving preoperative TRACE with concurrent chemoradiotherapy (TRACE‐CRT group, N = 60) and the control group receiving only neoadjuvant chemoradiotherapy (CRT group, N = 58). All patients underwent surgery after their preoperative treatments.
Results
All patients successfully completed the surgical operation. No significant differences were found in sphincter preservation rate and R0 resection rate between TRACE‐CRT group and CRT group (p > 0.05). No significant differences were found between the two groups in terms of the perioperative indicators and postoperative complications except mean operation time (165.8 vs. 196.6 min, p < 0.001). Local recurrence occurred in 8 and 5 patients, respectively (p > 0.05). Distant metastasis occurred in 5 and 11 patients, respectively (p < 0.05).
Conclusions
Adding TRACE in the preoperative standard treatment for LARC did not increase perioperative complications. In addition, it has the potential advantage of preventing distant metastasis. It is worthy of further application and promotion in clinical practice.