Clinical and Oncological Impact of a Protective Ileostomy in Rectal Cancer Patients Undergoing Adjuvant Chemotherapy.

IF 1.6 4区医学 Q4 ONCOLOGY

Anticancer research Pub Date : 2024-11-01 DOI:10.21873/anticanres.17324

Alizée Zadoroznyj, Elias Karam, Nicolas Michot, Julien Thiery, Thiery Lecomte, Driffa Moussata, Sophie Chapet, Gilles Calais, Ephrem Salame, Urs Pabst-Giger, Mehdi Ouaissi

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引用次数: 0

Abstract

Background/aim: During low anterior rectal resection for rectal cancer, a protective ileostomy (PI) is routinely created to reduce the severity of anastomotic complications. The aim of this study was to investigate the side-effects of PI during adjuvant chemotherapy.

Patients and methods: A retrospective cohort of patients was operated on for non-metastatic rectal cancer with a PI during 2005-2022. Patients treated with adjuvant chemotherapy (AC) were compared with those not receiving AC. A subgroup analysis compared patients with early PI closure (<10 weeks) and those with a PI in place during chemotherapy.

Results: A total of 242 patients were included: 178 (73.6%) without adjuvant chemotherapy and 64 (26.4%) with. History, tumour location, neoadjuvant treatment and postoperative follow-up were similar for both groups. Patients treated with AC had a greater risk of renal failure (37.5% vs. 14.6%, p=0.0002), ionic disorders (45.3% vs. 26.9% p=0.008), malnutrition (23.4% vs. 5.6%, p=0.0002) and rehospitalization (35.9% vs. 18.5% p=0.007). Patients treated with AC needed significant dose adjustments of oxaliplatin in 40.6% of cases, this adjustment being higher in patients with a PI compared to patients with early closure (47.1 vs. 9.1%, p=0.021).

Conclusion: Presence of a PI during chemotherapy predisposes to increased episodes of renal failure, and requires major adaptation of chemotherapy doses, especially of oxaliplatin.

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保护性回肠造口术对接受辅助化疗的直肠癌患者的临床和肿瘤学影响

背景/目的：在直肠癌低位直肠前切除术中，为降低吻合口并发症的严重性，通常会建立保护性回肠造口（PI）。本研究旨在调查辅助化疗期间保护性回肠造口的副作用：2005-2022年间，对非转移性直肠癌患者进行了PI手术。将接受辅助化疗（AC）的患者与未接受 AC 的患者进行了比较。一项亚组分析比较了早期 PI 关闭的患者（结果：共纳入 242 例患者：178人（73.6%）未接受辅助化疗，64人（26.4%）接受了辅助化疗。两组患者的病史、肿瘤位置、新辅助治疗和术后随访情况相似。接受 AC 治疗的患者发生肾功能衰竭（37.5% 对 14.6%，P=0.0002）、离子紊乱（45.3% 对 26.9%，P=0.008）、营养不良（23.4% 对 5.6%，P=0.0002）和再次住院（35.9% 对 18.5% ，P=0.007）的风险更高。接受 AC 治疗的患者中有 40.6% 需要大幅调整奥沙利铂的剂量，与早期封闭的患者相比，PI 患者的剂量调整幅度更大（47.1% 对 9.1%，P=0.021）：结论：化疗期间存在PI容易增加肾衰竭的发作，需要对化疗剂量进行重大调整，尤其是奥沙利铂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.