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.

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Author:Cihan Gani, Pierluigi Bonomo, Kerstin Zwirner, Christopher Schroeder, Apostolos Menegakis, Claus RödelORCiDGND, Daniel Zips
Pubmed Id:
Parent Title (English):Clinical and translational radiation oncology
Place of publication:Amsterdam
Document Type:Article
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
Page Number:7
First Page:9
Last Page:15
© 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 (
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0