Prospective audit following the introduction of short-course preoperative radiotherapy for rectal cancer

Background: The value of introducing a short course of preoperative radioth erapy before operation for rectal cancer is still subject to debate. Methods: One hundred consecutive patients, of mean age 68 (range 29-87) yea rs undergoing pre- operative radiotherapy for rectal cancer between January 1997 and December 1998 at two radiotherapy centres were audited prospectiv ely . Results: The time from referral to radiotherapy was 33 (11-74) days and fro m radiotherapy to operation 5 (1-42) days. There was a higher than expected anastomotic leak rate (15 per cent) and perineal wound infection rate (18 per cent). Patients waiting more than 7 days were more likely to suffer per ineal wound breakdown: 15 per cent (n = 39) versus 30 per cent (n = 10). Conclusion: The high anastomotic leak and perineal wound infection rates su ggest that the introduction of preoperative radiotherapy combined with tota l mesorectal excision should be audited carefully or performed as part of t he CRO7 trial.