Complications of antitumor treatment of rectal cancer: structural features and prerequisites for development

AIM : to find structural features and prerequisites for the development of complications of antitumor treatment of rectal cancer. PATIENTS AND METHODS : for the analysis, a cohort of 302 patients was formed who were treated in 2017–2018. The inclusion criterion was verified rectal cancer. The study was retrospective, the primary endpoint was the complication rate of antitumor treatment. The distribution of patients by gender was almost equal: 148/302 (49.0%) women and 154/302 (51.0%) men. The age of patients ranged from 31 to 86 (65.2 ± 9.9) years. All 100% of patients underwent surgery for a rectal tumor. In 145 (48.0%) patients, treatment was limited to a surgical aid, in 28 (9.3%) — was supplemented with radiation therapy, in 86 (28.5%) — chemotherapy, in 43 (14.2%) a combination of all three treatment methods was used. RESULTS: complications of antitumor treatment occurred in 118 (39.1%) patients. The vast majority of them — 95 (31.5%) cases — were postoperative. About half of them were associated with wound healing — 47 (15.5%). The most significant predictors of complications were the tumour differentiation (Area under the curve (AUC) = 0.58; 95% confidence interval (CI): 0.52–0.64; р = 0.007) and the tumour distance from the distal margin to the dentate line (AUC = 0.63; 95% CI: 0.53–0.64; p = 0.0009). In the structure of comorbidity, a significantly high probability of treatment complications was detected in patients with diabetes mellitus (RR = 4.05; 95% CI: 3.16–5.20; p < 0.0001), obesity (RR = 3.11; 95% CI: 2.52–3.83; p < 0.0001), varicose veins of the lower extremities (RR = 1.81; 95% CI: 1.36–2.41; p < 0.0001). CONCLUSION : the available statistically confirmed data on the prognostic potential of each analyzed indicator can be used in the future to compile an algorithm for the formation of risk groups even before the start of antitumor treatment of rectal cancer.