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Background <p>The 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.</p> Methods <p>In 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 (<i>n</i> = 112, mFOLFOX6 regimen) or the non-NAC group (<i>n</i> = 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.</p> Results <p>Baseline demographic and clinical characteristics were similar between groups. The NAC group demonstrated a higher rate of anus preservation (54.46% vs. 39.13%; <i>P</i> = 0.021), shorter postoperative recovery times, and reduced hospital stay compared to the non-NAC group (all <i>P</i> &lt; 0.05). At 7 days and 6 months postoperatively, the NAC group had significantly lower levels of CEA, CA19-9, and AFP (all <i>P</i> &lt; 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 (<i>P</i> &lt; 0.05) and higher rates of leukopenia (8.04% vs. 0.87%; <i>P</i> = 0.021) and neutropenia (7.14% vs. 0.87%; <i>P</i> = 0.037). Major postoperative complication rates did not differ significantly between groups.</p> Conclusion <p>Neoadjuvant 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.</p> Trial Registration <p>Not applicable.</p>

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Impact of Neoadjuvant Chemotherapy on Perioperative Tumor Marker Dynamics and Postoperative Recovery in Patients Undergoing Laparoscopic Radical Resection for Rectal Cancer

  • 期刊论文

  • 发表日期：

    2025年12月12日

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  • Leibin Shen,
  • Zhenglei Fei,
  • Tao Peng,
  • Liangbin Jin,
  • Jianfeng Wang

摘要

Background

The 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.

Methods

In 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.

Results

Baseline 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.

Conclusion

Neoadjuvant 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 Registration

Not applicable.