Do improvements in surgical technique mean it is time to be more selective in our approach to neoadjuvant radiotherapy for rectal cancer? Journal Article
| Author: | Weiser, M. R. |
| Article Title: | Do improvements in surgical technique mean it is time to be more selective in our approach to neoadjuvant radiotherapy for rectal cancer? |
| Abstract: | Surgery is the mainstay of treatment for rectal cancer. Widespread use of total mesorectal excision (TME) has greatly reduced local recurrence, improved survival, and made it possible for most patients to avoid a permanent stoma. Combined modality therapy (CMT) has improved overall results and is now standard treatment for stage II and III rectal cancer. However, CMT has risks: toxicity, delayed chemotherapy, and potential overtreatment. Several investigators report that, for some patients, equivalent recurrence-free and overall survival are possible with TME alone. Many patients can be stratified for treatment according to risk status assessed on the basis of T/N classification, and some may benefit from a more limited approach that excludes pelvic radiation. A multi-institutional prospective, randomized controlled trial is in progress to address this question. As preoperative staging and our understanding of tumor biology continue to improve, we will be better able to assess risk and deliver rectal cancer treatment selectively. © 2014 Springer Science+Business Media New York. |
| Keywords: | cancer chemotherapy; cancer surgery; multimodality cancer therapy; cancer adjuvant therapy; cancer radiotherapy; combined modality therapy; chemotherapy; cancer staging; nuclear magnetic resonance imaging; antineoplastic agent; computer assisted tomography; risk factor; therapy delay; surgery; preoperative treatment; rectum cancer; chemoradiation; chemoradiotherapy; rectal cancer; total mesorectal excision; preoperative radiotherapy; human; article; downsizing; downstaging |
| Journal Title: | Current Colorectal Cancer Reports |
| Volume: | 10 |
| Issue: | 2 |
| ISSN: | 1556-3790 |
| Publisher: | Springer |
| Date Published: | 2014-06-01 |
| Start Page: | 173 |
| End Page: | 179 |
| Language: | English |
| DOI: | 10.1007/s11888-014-0219-4 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 1 August 2014 -- Source: Scopus |
