ABSTRACT
The optimal management of locally advanced rectal cancer requires a multidisciplinary strategy involvingsurgical resection with total mesorectal excision and combined use of radiotherapy and chemotherapy. Thesequence of treatment can either be preoperative chemoradiation followed by surgery or upfront surgeryfollowed by postoperative chemoradiation. This study compared survival outcomes of these two aforementionedapproaches in 76 stage III rectal cancer patients, identified in the hospital database and treated between 2008and 2014. The median locoregional recurrence free survival in the preoperative group was 34 months whereasit was 33 months in the postoperative group (p=0.583). The median distant metastases free survival was 17months in the preoperative group versus 38 months in the postoperative group (p=0.039). The mean survivalin the whole cohort was 46.97 months with 27 deaths reported at the time of last follow up. The meansurvival in the preoperative group was 35.927 months versus 51.519 months in the postoperative radiotherapygroup (p=0.129). In our set of patients, the sequence of chemoradiation whether preoperative or postoperativedoes not lead to differential survival.