Neoadjuvant chemotherapy for rectal cancer does not impair postoperative bowel function

Neoadjuvant chemotherapy alone does not seem to trigger low anterior resection syndrome (LARS) during rectal cancer treatment, a recent study has found.

Researchers prospectively enrolled 97 rectal cancer patients (mean age, 59.86±10.91 years; 62.9 percent men) who had undergone surgery, of whom 20 had received neoadjuvant chemotherapy (group A); the remaining 77 had not (group B). Bowel function was assessed at 1, 3, and 6 months after the procedure using the LARS score.

The incidence rate of major LARS at 1 month after surgery was 10.3 percent. At 3 and 6 months, corresponding rates were 11.3 percent and 5.1 percent. LARS scores were not significantly different between groups A and B at any time point, neither were there any differences in the rate of occurrence of major LARS.

In both groups, LARS score significantly decreased with time (group A: p=0.023; group B: p<0.001); the same remained true when considering the overall cohort (p<0.001). Pairwise comparisons showed that among patients who did not receive neoadjuvant chemotherapy, the changes from 3–6 months (p=0.037) and from 1–6 months (p=0.007) were statistically significant.

In contrast, despite an overall significant improvement in bowel function, none of the pairwise comparisons in group A were statistically significant.

Nevertheless, Chi-square and Fisher’s exact tests found that neoadjuvant chemotherapy was not a significant correlate of the development of major LARS.

“Neoadjuvant chemotherapy does not have a negative impact on postoperative bowel function, and it may be a potential treatment choice for patients with significant risk factors for LARS,” the researchers said.

“More prospective studies with larger cohorts are still needed to better evaluate the outcomes, especially short-term studies comparing different types of neoadjuvant therapies and studies with longer follow-up periods that extends beyond the first 6 months following surgery,” they added.