dc.rights.license | CC-BY-NC-ND | |
dc.contributor | M.E. Verweij MD 1, J. Franzen MD 1, W.M.U. van Grevenstein MD PhD 1, H.M. Verkooijen MD PhD 1*, M.P.W. Intven MD PhD 1* | |
dc.contributor.advisor | Verkooijen, Lenny | |
dc.contributor.author | Verweij, Maaike | |
dc.date.accessioned | 2023-06-01T00:00:43Z | |
dc.date.available | 2023-06-01T00:00:43Z | |
dc.date.issued | 2023 | |
dc.identifier.uri | https://studenttheses.uu.nl/handle/20.500.12932/43949 | |
dc.description.abstract | Background: A prolonged interval between short course radiotherapy (SCRT, 25 Gy in 5 fractions) and surgery for rectal cancer (4-8 weeks, SCRT-delay) has been associated with a lower postoperative complication rate and higher pathological complete response (pCR) rate than SCRT and surgery within a week (SCRT-direct surgery). The current study sought to confirm these associations in nationwide real-world data of Dutch rectal cancer patients.
Method: Patients with intermediate risk rectal cancer (T3(MRF-)N0M0 and T1-3(MRF-)N1M0) treated with either SCRT-delay (4-12 weeks) or SCRT-direct surgery in 2018-2021 were selected from a nationwide Dutch cohort. Confounders were eliminated using inverse probability of treatment weighting (IPTW). The 90-day postoperative complication rate and pathological complete response (pCR) rate were compared using log-binomial and Poisson regression.
Results: 664 patients were included in the SCRT-direct surgery and 238 in the SCRT-delay group. After IPTW, the 90-day postoperative complication rate was comparable between SCRT-direct surgery and SCRT-delay (40% vs. 42%, RR = 1.1 [95%confidence interval (CI): 0.9; 1.3], p=0.6). pCR occurred more often following SCRT-delay than following SCRT-direct surgery (10% vs. 0.3%, RR = 39 [95%CI: 11, 139], p < 0.001).
Conclusion: Real-world evidence could not confirm an advantage in postoperative complications following SCRT-delay compared to SCRT-direct surgery, but did confirm the increased pCR rate following SCRT-delay. SCRT-delay followed by a response assessment should be offered to patients who are interested in watch & wait strategy. SCRT-direct surgery still is a valid option for patients who prefer surgical management. | |
dc.description.sponsorship | Utrecht University | |
dc.language.iso | EN | |
dc.subject | Deze scriptie onderzocht of een verlengd interval (4-8 weken) tussen kort schema radiotherapie en operatie voor endeldarmkanker in minder postoperatieve complicaties en meer pathologische complete respons resulteerde dan direct opereren (< 1 week) in real-world data. | |
dc.title | Timing of surgery after short course radiotherapy for rectal cancer: real-world evidence | |
dc.type.content | Postgraduate Master Thesis | |
dc.rights.accessrights | Open Access | |
dc.subject.keywords | postoperative complications; pathological complete response; rectal cancer; short course radiotherapy; inverse probability of treatment weighting; real-world data | |
dc.subject.courseuu | Epidemiology Postgraduate | |
dc.thesis.id | 12123 | |