Suppression of the postoperative neutrophil leucocytosis following neoadjuvant chemoradiotherapy for rectal cancer and implications for surgical morbidity

Kerr, Stuart and Klonizakis, Markos and Glynne-Jones, Robert (2010) Suppression of the postoperative neutrophil leucocytosis following neoadjuvant chemoradiotherapy for rectal cancer and implications for surgical morbidity. Colorectal Disease, 12 (6). pp. 549-554. ISSN 1462-8910

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Full text URL: http://dx.doi.org/10.1111/j.1463-1318.2009.01858.x

Abstract

Objective: The extent to which neoadjuvant chemoradio-
therapy for rectal cancer influences postoperative morbid-
ity is controversial. This study investigated whether this
treatment suppresses the normal perioperative inflamma-
tory response and explored the clinical implications.
Method: Prospective databases were queried to identify
37 consecutive study patients undergoing definitive
surgery following 5-FU ⁄ capecitabine-based chemoradio-
therapy and 35 consecutive untreated control patients
operated upon for rectal or rectosigmoid cancer. Preop-
erative (< 10 days) and postoperative (< 24 h) neutrophil
counts, along with morbidity data, were confirmed
retrospectively. Univariate and multivariate analyses
assessed the apparent effect of chemoradiotherapy on
change in neutrophil count. The latter’s association with
postoperative morbidity was then examined.
Results: Sufficient data were available for 34 study and
27 control patients. Repeated-measures ANCOVA
revealed significant differences between their periopera-
tive neutrophil counts (P = 0.02). Of the other charac-
teristics which differed between the groups, only age
and tumour location were prognostically significant
regarding perioperative change in neutrophil count.
Accounting for relevant covariates, chemoradiotherapy
was significantly associated with a suppressed perioper-
ative neutrophil leucocytosis. Local postoperative com-
plications affected 25 of 61 patients, who had lower
perioperative neutrophil increases than their counter-
parts (P = 0.016).
Conclusion: Chemoradiotherapy appears to suppress the
perioperative inflammatory response, thereby increasing
susceptibility to local postoperative complications.

Item Type:Article
Additional Information:Objective: The extent to which neoadjuvant chemoradio- therapy for rectal cancer influences postoperative morbid- ity is controversial. This study investigated whether this treatment suppresses the normal perioperative inflamma- tory response and explored the clinical implications. Method: Prospective databases were queried to identify 37 consecutive study patients undergoing definitive surgery following 5-FU ⁄ capecitabine-based chemoradio- therapy and 35 consecutive untreated control patients operated upon for rectal or rectosigmoid cancer. Preop- erative (< 10 days) and postoperative (< 24 h) neutrophil counts, along with morbidity data, were confirmed retrospectively. Univariate and multivariate analyses assessed the apparent effect of chemoradiotherapy on change in neutrophil count. The latter’s association with postoperative morbidity was then examined. Results: Sufficient data were available for 34 study and 27 control patients. Repeated-measures ANCOVA revealed significant differences between their periopera- tive neutrophil counts (P = 0.02). Of the other charac- teristics which differed between the groups, only age and tumour location were prognostically significant regarding perioperative change in neutrophil count. Accounting for relevant covariates, chemoradiotherapy was significantly associated with a suppressed perioper- ative neutrophil leucocytosis. Local postoperative com- plications affected 25 of 61 patients, who had lower perioperative neutrophil increases than their counter- parts (P = 0.016). Conclusion: Chemoradiotherapy appears to suppress the perioperative inflammatory response, thereby increasing susceptibility to local postoperative complications.
Keywords:Rectal cancer, surgery, postoperative complications, immunosuppression, leucocyte, neoadjuvant chemoradiotherapy
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science > School of Health & Social Care
ID Code:3559
Deposited By:INVALID USER
Deposited On:31 Oct 2010 16:00
Last Modified:13 Mar 2013 08:49

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