RT Journal Article
SR Electronic
T1 Clinical and Oncological Impact of a Protective Ileostomy in Rectal Cancer Patients Undergoing Adjuvant Chemotherapy
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 4995
OP 5005
DO 10.21873/anticanres.17324
VO 44
IS 11
A1 ZADOROZNYJ, ALIZÉE
A1 KARAM, ELIAS
A1 MICHOT, NICOLAS
A1 THIERY, JULIEN
A1 LECOMTE, THIERY
A1 MOUSSATA, DRIFFA
A1 CHAPET, SOPHIE
A1 CALAIS, GILLES
A1 SALAME, EPHREM
A1 PABST-GIGER, URS
A1 OUAISSI, MEHDI
YR 2024
UL http://ar.iiarjournals.org/content/44/11/4995.abstract
AB 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.