Organ preservation in rectal cancer – challenges and future strategies
- 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.
Author: | Cihan Gani, Pierluigi Bonomo, Kerstin Zwirner, Christopher Schroeder, Apostolos Menegakis, Claus RödelORCiDGND, Daniel Zips |
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URN: | urn:nbn:de:hebis:30:3-463355 |
DOI: | https://doi.org/10.1016/j.ctro.2017.02.002 |
ISSN: | 2405-6308 |
Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/29658007 |
Parent Title (English): | Clinical and translational radiation oncology |
Publisher: | Elsevier |
Place of publication: | Amsterdam |
Document Type: | Article |
Language: | English |
Year of Completion: | 2017 |
Date of first Publication: | 2017/03/23 |
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Release Date: | 2018/04/19 |
Tag: | Chemoradiotherapy; Organ preservation; Radiochemotherapy; Radiotherapy; Rectal cancer; Wait and see |
Volume: | 3 |
Page Number: | 7 |
First Page: | 9 |
Last Page: | 15 |
Note: | © 2017 The Authors. Published by Elsevier Ireland Ltd on behalf of European Society for Radiotherapy and Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
HeBIS-PPN: | 43186232X |
Institutes: | Medizin / Medizin |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Licence (German): | Creative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0 |