Impaired postoperative neutrophil leucocytosis and acute complications following short course preoperative radiotherapy for operable rectal cancer

Eur J Surg Oncol. 2003 Mar;29(2):155-7. doi: 10.1053/ejso.2002.1364.

Abstract

Aim: Postoperative mortality following total mesorectal excision is increased if this is performed more than 3 days after the completion of short course preoperative radiotherapy. Suppression of neutrophil leucocytosis which is normally seen following surgery has been a suggested reason. This study was to determine the relationship between postoperative complications and perioperative neutrophil counts.

Method: A database of 176 patients treated at a single radiotherapy centre in 1998 and 1999 was used. A two-sample Wilcoxon test was used to compare preoperative neutrophil counts, postoperative neutrophil counts and their ratio in patients with and without complications.

Results: There was no association between acute complications and preoperative (P = 0.25) or postoperative (P = 0.45) neutrophil count. The post/preoperative ratio was significantly higher in patients without complications (median 1.61 vs 1.16, P = 0.02).

Conclusions: There appears to be an inverse relationship between the magnitude of postoperative neutrophil leucocytosis and the risk of acute complications following short course preoperative radiotherapy.

MeSH terms

  • Acute Disease
  • Combined Modality Therapy
  • Humans
  • Leukocyte Count
  • Leukocytosis / etiology*
  • Neutrophils*
  • Postoperative Complications*
  • Rectal Neoplasms / blood
  • Rectal Neoplasms / radiotherapy*
  • Rectal Neoplasms / surgery
  • Risk Factors