Results
Between January 2000 and December 2009 387 patients were operated for rectal cancer. In this cohort 106 patients were identified who received an intensified neoadjuvant RCT. These patients were matched with 106 patients, who did not receive any neoadjuvant treatment, for tumor height, discontinuous resection/exstirpation, T-category of the TNM-system, diverting stoma and UICC stage. To rule out, that only the good cases were matched from the not neoadjuvantly treated group, we analyzed the not neoadjuvantly treated group in terms of matched and not matched patients. The main differences were, that the not matched patients had a higher tumor localization and a more frequent operative revision.
Table 1 shows the matching results. As expected, the number of evaluated lymph nodes was higher in patients without neoadjuvant treatment.
Table 2 shows the complications of the two groups. There were no differences in mortality and overall complications. Non surgical complications were higher in the not neoadjuvant treated group. Surgical complications were significantly different. The anastomosis leakage rate was 3 fold higher in the neoadjuvantly treated group. There was a difference in leakage rate between men and women in the study-group (16.1%) and within the control group (13.5%), which did not reach statistical significance. The perineal wound infection rate in patients with a rectum exstirpation was more than 2-fold, the revision rate was more than 3-fold higher after neoadjuvant RCT. The overall surgical morbidity is also significantly higher after neoadjuvant RCT.