ArticleJournal of gastrointestinal cancer2025
Impact of Neoadjuvant Chemotherapy on Perioperative Tumor Marker Dynamics and Postoperative Recovery in Patients Undergoing Laparoscopic Radical Resection for Rectal Cancer.
Article in Journal of gastrointestinal cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe impact of neoadjuvant chemotherapy (NAC) on perioperative and functional outcomes for patients undergoing laparoscopic radical resection for rectal cancer remains incompletely understood. This study aimed to compare surgical, biochemical, functional, and immunologic outcomes between patients receiving NAC and those undergoing surgery alone.
methodsIn this retrospective cohort study, 231 patients who underwent laparoscopic radical resection for rectal cancer between January 2020 and January 2025 were analyzed. Patients were assigned to either the NAC group (n = 112, mFOLFOX6 regimen) or the non-NAC group (n = 115) based on preoperative chemotherapy status. Baseline characteristics, surgical and recovery parameters, serum tumor biomarkers (CEA, CA19-9, AFP), anorectal dynamics, and immune cell subsets (CD3+, CD4+, CD4+/CD8+) were measured at specified time points. Postoperative complications and adverse reactions were recorded.
resultsBaseline demographic and clinical characteristics were similar between groups. The NAC group demonstrated a higher rate of anus preservation (54.46% vs. 39.13%; P = 0.021), shorter postoperative recovery times, and reduced hospital stay compared to the non-NAC group (all P < 0.05). At 7 days and 6 months postoperatively, the NAC group had significantly lower levels of CEA, CA19-9, and AFP (all P < 0.05). Anorectal dynamic assessment showed improved functional recovery in the NAC group at 7 days postoperatively. However, the NAC group exhibited a greater reduction in peripheral CD3+, CD4+, and CD4+/CD8 + levels postoperatively (P < 0.05) and higher rates of leukopenia (8.04% vs. 0.87%; P = 0.021) and neutropenia (7.14% vs. 0.87%; P = 0.037). Major postoperative complication rates did not differ significantly between groups.
conclusionNeoadjuvant chemotherapy prior to laparoscopic radical resection for rectal cancer was associated with improved anus preservation, enhanced postoperative recovery, and greater biochemical and functional benefits without increasing major complication rates, although it was linked to higher hematologic adverse events and postoperative declines in immune cell counts.
trial registrationNot applicable.
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