Organ preservation in rectal cancer – Challenges and future strategies. (April 2017)

• Record Type: Journal Article
• Authors: Gani, C.; Bonomo, P.; Zwirner, K.; Schroeder, C.; Menegakis, A.; Rödel, C.; Zips, D.
• Is Part Of: Clinical and translational radiation oncology. Volume 3(2017)
• Page Start: 9
• Page End: 15
• Publication Date: 2017-04
• Subjects: Rectal cancer -- Wait and see -- Organ preservation -- Radiochemotherapy -- Radiotherapy -- Chemoradiotherapy; Cancer -- Radiotherapy -- Periodicals; Oncology -- Periodicals; Cancer -- Radiotherapy; Oncology; Radiation Oncology; Neoplasms -- radiotherapy; Translational Medical Research; Periodicals; Electronic journals; Periodicals; 616.9940642
• DOI: 10.1016/j.ctro.2017.02.002
• Languages: English
• ISSNs: 2405-6308

Abstract

Abstract: Neoadjuvant radiochemotherapy with subsequent total mesorectal excision is the standard of care for locally advanced rectal cancer. While this multimodal strategy has decreased local recurrences rates below 5%, long-term morbidities are considerable in terms of urinary, sexual or bowel functioning. At the same time approximately 10–20% of patients have no evidence of residual tumour in their surgical specimen. Pioneering studies from Brazil have suggested that surgery can safely be omitted in carefully selected patients with a clinical complete response after radiochemotherapy. Although confirmatory studies showed similar results, challenges in terms of optimizing radiochemotherapy for organ-preservation, appropriate selection of patients for non-operative management and the safety of this approach remain. The present review will summarize the current data on organ-preservation in rectal cancer and discuss the challenges that need to be addressed in future trials.