Skip to main content
2025 ASCRS Annual Scientific Meeting Main banner
Final Program


Visit ASCRS U
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
CME
CME
Invitation/Ticketed Event
Invitation/Ticketed Event
Invited Lectureship
Invited Lectureship
Award Recipient
Award Recipient
Self-Assessment
Self-Assessment
Social
Social
Industry
Industry
Back

Session: ePoster: Colon and Colorectal Cancer 13 (Mon1015)

EP706 - Factors associated with using neoadjuvant chemoradiotherapy in upper rectal cancers

Monday, May 12, 2025
10:42 AM – 10:47 AM PT

    ePoster Presenter(s)

  • Yosef Nasseri, MD, FACS, FASCRS

    General and colorectal surgeron
    Cedar-Sinai Medical Center
    Los Angeles, CA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • AS

    Andrea Paola P. Solis Pazmino, 1804664892

    Surgery Resident
    Surgery Group Los Angeles
    Porto Alegre, Rio Grande do Sul, Brazil

    Disclosure information not submitted.

  • JW

    Joshua Wolf, MD FACS FASCRS

    Division Chief, Colorectal Surgery
    LifeBridge Health
    Baltimore, Maryland, United States

    Disclosure information not submitted.

  • Rachel Ma

    Research Coordinator
    Surgery Group of Los Angeles
    Los Angeles, CA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • MB

    Moshe Barnajian, n/a

    Colorectal Surgery
    Surgery Group Los Angeles
    Los Angeles, California, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Yosef Nasseri, MD, FACS, FASCRS: This individual has no financial relationships with ineligible companies.
Rachel Ma: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Neoadjuvant chemoradiation (NACR) is a crucial component of the multimodal treatment for stage II and III rectal cancers, conferring improved local control rates and sphincter preservation. NACR is mainly used in mid and low-rectal cancers. However, the rate and factors associated with using NACR in upper rectal cancer (URC) remain unclear. This study aimed to assess the factors related to using NACR for URC.

Methods/Interventions: This case-control retrospective study used data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2017–2022. We included patients with stage II/III URC who underwent proctectomy with and without NACR. The primary outcome was receipt of NACR and the secondary outcome was complications.

Results/Outcomes: We included 635 patients with URC, of whom 176 (27.7%) received NACR and 394 (73.3%) underwent upfront surgery (UFS). The median age was 63 years and most patients were male (59.5%) and non-Hispanic white (75.6%), with a mean BMI of 28.2 kg/m2. On multivariate analysis, factors independently associated with increased NACR use included Black race (OR 6.21; 95% CI, 1.02 -118.06; p 0.056), clinical T3 stage (OR 11.56; 95% CI, 2.57- 84.95; p 0.004), and clinical T4 stage (OR 21.75; 95% CI, 4.00- 184.75; p 0.001). Conversely, older patients (OR 0.96; 95% CI, 0.94-0.98; p < 0.012) were less likely to receive NACR (AUC 0.8; 95% CI: 0.62-0.96). Compared to UFS, NACR was associated with significantly higher rates of total complications (25.7% vs. 23.9%), major complications (20.6% vs. 17.3%), organ space infection (5.7% vs. 4.1%, p=0.001), septic shock (2.8% vs. 0.5%, p=0.008), UTI (2.3% vs. 1.3%, p=0.003), and DVT (1.1% vs. 0.5%, p=0.046), but lower rates of acute renal failure, sepsis, pneumonia, myocardial infarction, and superficial SSI.

Conclusion/Discussion: The study found that Black race and advanced tumor T stage were associated with increased use of NACR in URC, while older age was linked to reduced use of NACR. NACR was associated with higher rates of complication, specifically organ space infection and severe sepsis compared to UFS. These results call for careful weighing of the benefits against the adverse effects of NACR in URC.