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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 9/2013

01.09.2013 | Colorectal Cancer

Modern Rectal Cancer Multidisciplinary Treatment: The Role of Radiation and Surgery

verfasst von: Marco E. Allaix, MD, Alessandro Fichera, MD, FACS, FASCRS

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2013

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Abstract

Introduction

Treatment of rectal cancer has evolved during the last few decades due to more in-depth knowledge of rectal cancer biology and major advances in the field of preoperative staging, medical management and surgical techniques. Consequently, treatment strategies are shifting moving towards a more personalized approach based on the response to treatment. Currently topics of controversy are centered around the indication for neoadjuvant radiation therapy in locally advanced rectal cancer and the role of surgery in patients with complete clinical response after neoadjuvant combined modality therapy. This manuscript aims to critically evaluate the evolution of treatment of rectal cancer during the last three decades and future directions.

Methods

A review of the literature has been performed in PubMed/Medline electronic databases.

Results

Treatment modalities are moving towards a tailored approach to rectal cancer patients based on the response to chemoradiation. A “wait-and-see” approach and local excision by Transanal Endoscopic Microsurgery (TEM) are strategies recently proposed in case of complete clinical response.

Conclusions

The standard of care still requires that locally advanced rectal cancer should be treated by neoadjuvant chemoradiation therapy followed by total mesorectal excision, including patients with a clinical complete response. Further evidence is needed to endorse a “wait-and-see” strategy and to define the role of TEM.
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Metadaten
Titel
Modern Rectal Cancer Multidisciplinary Treatment: The Role of Radiation and Surgery
verfasst von
Marco E. Allaix, MD
Alessandro Fichera, MD, FACS, FASCRS
Publikationsdatum
01.09.2013
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2013
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-2966-x

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