Surgery should not be delayed in patients with locally advanced rectal cancer who do not respond well to neoadjuvant chemoradiation, Italian doctors warn.

The advice follows results from a multicentre, retrospective cohort study showing that a longer interval between chemoradiotherapy (CRT) and total mesorectal excision (TME) is associated with worse survival rates in such patients.

The study, which is the first to specifically explore the impact of delayed surgery following CRT on patient outcomes, provides sufficient evidence for “an immediate revision of current practice”, the researchers say.

The team analysed data from 1064 patients with locally advanced rectal cancer (median age 64) to assess the impact of short (≤8 weeks) and long (>8 weeks) waiting periods between CRT and surgery on survival outcomes.