Research Article Does Extending the Waiting Time of Low-Rectal Cancer Surgery after Neoadjuvant Chemoradiation Increase the Perioperative Complications? Kittinut Timudom, 1 Natthawut Phothong, 2 Thawatchai Akaraviputh, 1 Vitoon Chinswangwatanakul, 1 Ananya Pongpaibul, 3 Janjira Petsuksiri, 4 Suthinee Ithimakin, 5 and Atthaphorn Trakarnsanga 1 1 Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Tailand 2 Department of Surgery, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Tailand 3 Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Tailand 4 Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Tailand 5 Division of Medical Oncology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Tailand Correspondence should be addressed to Atthaphorn Trakarnsanga; atthaphorn.tra@mahidol.ac.th Received 24 June 2016; Accepted 1 September 2016 Academic Editor: Alessandro Passardi Copyright © 2016 Kittinut Timudom et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Traditionally, rectal cancer surgery is recommended 6 to 8 weeks afer completing neoadjuvant chemoradiation. Extending the waiting time may increase the tumor response rate. However, the perioperative complication rate may increase. Te purpose of this study was to determine the association between extending the waiting time of surgery afer neoadjuvant chemoradiation and perioperative outcomes. Methods. Sixty patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation followed by radical resection at Siriraj hospital between June 2012 and January 2015 were retrospectively analyzed. Demographic data and perioperative outcomes were compared between the two groups. Results. Te two groups were comparable in term of demographic parameters. Te mean time interval from neoadjuvant chemoradiation to surgery was 6.4 weeks in Group A and 11.7 weeks in Group B. Te perioperative outcomes were not signifcantly diferent between Groups A and B. Pathologic examination showed a signifcantly higher rate of circumferential margin positivity in Group A than in Group B (30% versus 9.3%, resp.;  = 0.04). Conclusions. Extending the waiting to >8 weeks from neoadjuvant chemoradiation to surgery did not increase perioperative complications, whereas the rate of circumferential margin positivity decreased. 1. Background In Tailand, colorectal cancer is the third most common cancer afer liver and lung cancer in men and the ffh most common cancer afer cervix, breast, liver, and lung cancer in women. Approximately one-third of Tai patients with colorectal cancer have metastatic disease [1]. Neoadju- vant chemoradiation (nCRT) followed by total mesorectal excision (TME) is the preferred treatment for the locally advanced rectal cancer (clinical stage T3 or T4 or node- positive disease). Tis treatment regimen has many benefts, including improved local control, reduced toxicity, and an increased incidence of sphincter-salvage operations [2, 3]. In 2004, Sauer et al. [2] published a randomized study of 799 patients with locally advanced rectal cancer. Tese patients were divided into a preoperative long-course chemoradio- therapy group and a postoperative chemoradiotherapy group. Te authors found that preoperative chemoradiotherapy followed by radical surgery with TME 6 weeks afer the completion of chemoradiotherapy was associated with an improved tumor response rate, reduced chemoradiotherapy- related toxicity, decreased 5-year local recurrence rate, and increased sphincter preservation rate. Nonetheless, the 5- year disease-free survival and overall survival rates were Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2016, Article ID 7870815, 5 pages http://dx.doi.org/10.1155/2016/7870815