This investigation sought to assess the comparative effects of preoperative chemoradiotherapy (CRT) and postoperative CRT on the survival and sphincter preservation of patients diagnosed with locally advanced rectal cancer.

A retrospective analysis was conducted on a cohort of 466 patients diagnosed with locally advanced rectal cancer, who underwent either preoperative or postoperative CRT. We employed the Kaplan-Meier method to evaluate overall survival between the preoperative and postoperative cohorts and utilized the Spearman test to examine the relationship between the chosen treatment strategy and sphincter preservation.

Between 2007 and 2017, we examined a total of 466 patients. Among these, 263 underwent preoperative CRT, while 203 received postoperative CRT. The analysis revealed no statistically significant difference in survival between the two treatment groups (fig 1). For patients with tumors located ≤5cm from the anal verge, sphincter preservation was observed in 30.4% of cases (28 out of 92) in the preoperative group, as compared to 24.3% (9 out of 37) in the postoperative group (p=0.49).

This study demonstrates that there is no statistically significant variance in survival outcomes between preoperative chemoradiotherapy and postoperative treatment. Moreover, both treatment approaches exhibit similar efficacy in preserving anal sphincter function, with neither being superior in this aspect.