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Postoperative morbi...
Postoperative morbidity and mortality in relation to leukocyte counts and time to surgery after short-course preoperative radiotherapy for rectal cancer
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Fokstuen, Tone (författare)
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- Holm, Torbjörn (författare)
- Karolinska Institutet
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- Glimelius, Bengt (författare)
- Karolinska Institutet,Uppsala universitet,Institutionen för onkologi, radiologi och klinisk immunologi
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(creator_code:org_t)
- Elsevier BV, 2009
- 2009
- Engelska.
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Ingår i: Radiotherapy and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 93:2, s. 293-297
- Relaterad länk:
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https://urn.kb.se/re...
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visa fler...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Preoperative radiotherapy for rectal cancer decreases local recurrence rates, but increases postoperative complications. Impaired postoperative leukocyte reaction after preoperative short-course radiotherapy has been reported. The aim was to assess postoperative morbidity and mortality in relation to leukocyte reaction and the time interval between radiotherapy and surgery. MATERIALS AND METHODS: A retrospective analysis of patients included in the Stockholm I and II trials, randomising patients to surgery alone or to 5 x 5 Gy with immediate surgery, identified pre- and postoperative leukocyte values for 274 patients. RESULTS: In the surgery alone group (n=144), all but three patients (2%) reacted with leukocytosis (ratio post/preoperative >1.0) on day 1 and all but 9 (6%) on day 5. In the radiotherapy group (n=130), 40 (31%) became leukopenic (<4 x 10(9) cells/L) after radiotherapy, 29 (22%) reacted abnormally (leukopenia or ratio < or =1.0) on day 1 and 66 (51%) on day 5 (all p<0.001). Preoperative leukocyte counts did not influence postoperative morbidity, but a poor response on day 1 increased the risk of sepsis (p<0.05) and mortality (6/29 (21%) vs. 6/101 (6%), p<0.05). An interval of 10 days or more between the start of radiotherapy and surgery also had an impact on mortality; 6/17 (35%) vs. 6/113 (5%), p=0.001. In a logistic regression analysis, the time interval and age were independent predictors of mortality. CONCLUSIONS: Impaired postoperative leukocyte reaction is frequent after short-course radiotherapy and increases the risk of postoperative complications and death. A longer than recommended radiotherapy-surgery interval also appears to be detrimental for postoperative death, independently of leukocyte response.
Nyckelord
- Rectal cancer
- Preoperative radiotherapy
- Leukocytes
- Morbidity
- Mortality
- Radiation-surgery interval
- MEDICINE
- MEDICIN
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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