Management of rectal cancer

2014 ◽  
pp. 36-45
Author(s):  
Genevieve Boland
Keyword(s):  
Rectal Cancer

Surgery, Radio- and Chemo- therapy for Multimodal Treatment of Rectal Cancer

Swiss Surgery ◽  
2001 ◽  
Vol 7 (6) ◽  
pp. 256-274 ◽  
Author(s):  
Link ◽  
Staib ◽  
Kornmann ◽  
Formentini ◽  
Schatz ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multimodal Treatment ◽  
Local Relapse ◽  
Phase Iii ◽  
Neoadjuvant Radiotherapy ◽  
Term Survival ◽  
Primary Tumors ◽  
Impact On Survival ◽  
Relapse Rates

The possibilities and results of multimodal treatment in rectal cancer were reviewed with respect to the results of surgical treatment only. Based on the results of 4 studies, reducing local relapse rates and increasing long term survival rates significantly, postoperative radiochemotherapy (RCT) + chemotherapy (CT) should remain the recommended standard for R0 resected UICC II and III rectal cancers. The addition of RT to adjuvant CT reduces local relapses without significant impact on survival (NSABP R-02). Vice versa, the addition of CT to RT or an improved CT in the RCT-concept prolongs survival. Preoperative neoadjuvant radiotherapy (RT) reduced local relapse rates in 9 studies, and extended survival in one study that evaluated all eligible patients. Preoperative RT reduced local relapse rates in addition to total mesorectal excision (TME) but did not extend survival. The preoperative RCT + CT downstages resectable and nonresectable tumors and induces a higher sphincter preservation rate. Phase III data justifying its routine use in all UICC II + III stages are not yet available. This treatment may be routinely applied in nonresectable primary tumors or local relapses. Preoperative RCT (or RT) may evolve as standard, if the patient selection is improved and postoperative morbidity and long term toxicity reduced. Intraoperative RT could be added to this concept or be used together with preoperative/postoperative RT at the same indications. Postoperative adjuvant RT reduced local relapses significantly in a single trial, and no impact on survival time is reported. Since postoperative RT is inferior to preoperative RT, this treatment cannot be recommended, if RT is chosen as a single treatment modality in adjunction to surgery. The results of local tumor excisions may be improved with pre- or postoperative RCT + CT. In the future, multimodal treatment of rectal cancer might be more effective, if individualized according to prognostic factors.

Darmkrebs-OP: Auf die Erfahrung kommt es an

2020 ◽  
Vol 52 (04) ◽  
pp. 162-164
Author(s):  
Frank Lichert
Keyword(s):  
Rectal Cancer ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Hospital Volume ◽  
Rectum Resection

Diers J et al. Nationwide in-hospital mortality rate following rectum resection for rectal cancer according to annual hospital volume in Germany. BJS Open 2020; doi:10.1002/bjs5.50254

Utility of EUS to identify the effective responders from rectal cancer patients who receive neo-adjuvant chemotherapy

Endoscopy ◽  
2011 ◽  
Vol 43 (S 03) ◽  
Author(s):  
Zhang Xiaoyin ◽  
Guo Xuegang ◽  
Wang Xin ◽  
Du Jianjun ◽  
Zhao Qingchuan ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Neo Adjuvant Chemotherapy

Verbesserung der Behandlungsstrategie für Low Rectal Cancer: Ergebnisse der prospektiven MERCURY II Studie

2014 ◽  
Vol 52 (08) ◽  
Author(s):  
S Stelzner ◽  
J Straßburg ◽  
N Battersby ◽  
P How ◽  
N West ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Low Rectal Cancer
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