Clin Colon Rectal Surg 2020; 33(06): 366-371
DOI: 10.1055/s-0040-1714241
Review Article

Nonoperative Management for T2 Low Rectal Cancer: A Western Approach

Laura Melina Fernandez
1   Angelita & Joaquim Gama Institute, São Paulo, Brazil
2   Champalimaud Foundation, Lisbon, Portugal
,
Guilherme Pagin São Julião
1   Angelita & Joaquim Gama Institute, São Paulo, Brazil
,
Bruna Borba Vailati
1   Angelita & Joaquim Gama Institute, São Paulo, Brazil
,
Angelita Habr-Gama
1   Angelita & Joaquim Gama Institute, São Paulo, Brazil
,
Rodrigo Oliva Perez
1   Angelita & Joaquim Gama Institute, São Paulo, Brazil
› Author Affiliations

Abstract

The possibility of organ preservation in early rectal cancer has gained popularity during recent years. Patients with early tumor stage and low risk for local recurrence do not usually require neoadjuvant chemoradiation for oncological reasons. However, these patients may be considered for chemoradiation exclusively for the purpose of achieving a complete clinical response and avoid total mesorectal excision. In addition, cT2 tumors may be more likely to develop complete response to neoadjuvant therapy and may constitute ideal candidates for organ-preserving strategies. In the setting where the use of chemoradiation is exclusively used to avoid major surgery, one should consider maximizing tumor response. In this article, we will focus on the rationale, indications, and outcomes of patients with early rectal cancer being treated by neoadjuvant chemoradiation to achieve organ preservation by avoiding total mesorectal excision.



Publication History

Article published online:
02 November 2020

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 
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