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Effects of Adjuvant Oxaliplatin on Anal Function in Locally Advanced Rectal Cancer Treated with Preoperative Chemo-Radiotherapy and Low Anterior Resection

Background: The main objective of this study was to find out if the application of adjuvant oxaliplatin (OXA) influences sphincter function in patients with locally advanced rectal cancer (LARC) treated with preoperative capecitabine/ radiotherapy followed by lower anterior resection (LAR).

Methods: Patients with LARC treated at our medical center with LAR and with absence of loco-regional relapse for at least two years were retrospectively analyzed independently of the type of adjuvant treatment that they received. Anal sphincter function was assessed by Wexner´s incontinence score (0 to 20 points, with score points inversely proportional to sphincter function). All questionnaires were completed between January 2010 and December 2012.

Sphincter function as assessed by the Wexner test was compared between patients with and without OX treatment, using the non-parametrical Mann-Whitney test. Statistical analyses were conducted with IBM SPSS Statistics package, version 20.

Results: 92 patients were included in our study since 2006. The mean time from LAR to fecal function assessment was 58 months (25 to 96 months). Wexner test median values did not differ significantly (p=0.450) between patients with and without adjuvant OXA. The median (IQR) for the group of patients without adjuvant OXA treatment was 6.0 (1.0-11.25), and of 5.0 (1.0-10.0) for the group that received adjuvant OXA.

Conclusions: Based on our findings, OXA could be used as adjuvant treatment in LARC according to the absence of deleterious effects over sphincter anal function. Due to the retrospective nature of our study, prospective studies should be warranted in similar scenarios.


Fernando Arias, Antonio Viudez, Clara Eito, Berta Ibanez-Beroiz, Gemma Asin, Irene Hernandez, Koldo Cambra, Marta Errasti, Marta Barrado, Maider Campo, Ignacio Visus, Sonia Flamarique and Miguel A Ciga

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