Neoadjuvant treatment can eliminate all tumor cells in some patients with rectal cancer,
but, with standard management, these patients are recognized only after rectal resection,
when their specimens show pathologic complete response.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Advances in SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Colorectal cancer statistics, 2020.CA Cancer J Clin. 2020; 70: 145-164
- Preoperative versus postoperative chemoradiotherapy for rectal cancer.N Engl J Med. 2004; 351: 1731-1740
- Colorectal cancer.Lancet. 2010; 375: 1030-1047
- Effect of adding mFOLFOX6 after neoadjuvant chemoradiation in locally advanced rectal cancer: a multicentre, phase 2 trial.Lancet Oncol. 2015; 16: 957-966
- Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data.Lancet Oncol. 2010; 11: 835-844
- Preliminary results of the organ preservation of rectal adenocarcinoma (OPRA) trial.J Clin Oncol. 2020; 38: 4008
- Treatment of cancer, particularly of the tongue, tonsil and rectum, by buried emanation.Am J Roentgenol. 1920; 7: 92
- Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results.Ann Surg. 2004; 240 ([discussion: 717–8]): 711-717
- Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer.J Clin Oncol. 2011; 29: 4633-4640
- Nonoperative management of rectal cancer after chemoradiation opposed to resection after complete clinical response. A comparative study.Eur J Surg Oncol. 2015; 41: 1456-1463
- Long-term outcome of an organ preservation program after neoadjuvant treatment for rectal cancer.J Natl Cancer Inst. 2016; 108: djw171
- High-dose chemoradiotherapy and watchful waiting for distal rectal cancer: a prospective observational study.Lancet Oncol. 2015; 16: 919-927
- Nonoperative management of rectal cancer with complete clinical response after neoadjuvant therapy.Ann Surg. 2012; 256: 965-972
- Complete clinical response to neoadjuvant chemoradiation in rectal cancers: can surgery be avoided?.Hepatogastroenterology. 2013; 60: 410-414
- Watch-and-wait approach versus surgical resection after chemoradiotherapy for patients with rectal cancer (the OnCoRe project): a propensity-score matched cohort analysis.Lancet Oncol. 2016; 17: 174-183
- Assessment of a Watch-and-Wait Strategy for Rectal Cancer in Patients With a Complete Response After Neoadjuvant Therapy.JAMA Oncol. 2019; 5: e185896
- A snapshot of the international views of the treatment of rectal cancer patients, a multi-regional survey: international tendencies in rectal cancer.World J Surg. 2020; 45: 302-312
- Organ Preservation in Rectal Cancer: The Patients' Perspective.Front Oncol. 2019; 9: 318
- Pilot study of patients' preferences for immediate resection versus a watch and wait approach after neoadjuvant chemoradiation for locally advanced rectal cancer.JCO Oncol Pract. 2020; 17: e149-e157
- Bowel function 14 years after preoperative short-course radiotherapy and total mesorectal excision for rectal cancer: report of a multicenter randomized trial.Clin Colorectal Cancer. 2015; 14: 106-114
- Preoperative staging of rectal cancer.Acta Oncol. 2008; 47: 20-31
- Lateral lymph node and its association with distant recurrence in rectal cancer: A clue of systemic disease.Surg Oncol. 2020; 35: 174-181
- Organ Preservation in cT2N0 Rectal Cancer After Neoadjuvant Chemoradiation Therapy: The Impact of Radiation Therapy Dose-escalation and Consolidation Chemotherapy.Ann Surg. 2019; 269: 102-107
- Randomized clinical trial of endoluminal locoregional resection versus laparoscopic total mesorectal excision for T2 rectal cancer after neoadjuvant therapy.Br J Surg. 2012; 99: 1211-1218
- Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer.Cancer. 2007; 109: 1750-1755
- Predictors for complete pathological response for stage II and III rectal cancer following neoadjuvant therapy - A systematic review and meta-analysis.Am J Surg. 2020; 220: 300-308
- P53 status as a predictive biomarker for patients receiving neoadjuvant radiation-based treatment: a meta-analysis in rectal cancer.PLoS One. 2012; 7: e45388
- Identification of a biomarker profile associated with resistance to neoadjuvant chemoradiation therapy in rectal cancer.Ann Surg. 2011; 254 ([discussion: 492–3]): 486-492
- DNA mismatch repair deficiency in rectal cancer: benchmarking its impact on prognosis, neoadjuvant response prediction, and clinical cancer genetics.J Clin Oncol. 2016; 34: 3039-3046
- Improved survival with preoperative radiotherapy in resectable rectal cancer.N Engl J Med. 1997; 336: 980-987
- Sequential short-course radiation therapy and chemotherapy in the neoadjuvant treatment of rectal adenocarcinoma.Radiat Oncol. 2019; 14: 147
- Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer.Br J Surg. 2006; 93: 1215-1223
- Improved Metastasis- and Disease-Free Survival With Preoperative Sequential Short-Course Radiation Therapy and FOLFOX Chemotherapy for Rectal Cancer Compared With Neoadjuvant Long-Course Chemoradiotherapy: Results of a Matched Pair Analysis.Int J Radiat Oncol Biol Phys. 2017; 99: 417-426
- Five fractions of radiation therapy followed by 4 cycles of FOLFOX chemotherapy as preoperative treatment for rectal cancer.Int J Radiat Oncol Biol Phys. 2014; 88: 829-836
- Compliance and tolerability of short-course radiotherapy followed by preoperative chemotherapy and surgery for high-risk rectal cancer - Results of the international randomized RAPIDO-trial.Radiother Oncol. 2020; 147: 75-83
- The Updated Results for the Phase 3 Study of 5×5 Gy Followed By Chemotherapy in Locally Advanced Rectal Cancer (STELLAR trial).Int J Radiat Oncol Biol Phys. 2017; 99: E157
- Management of Locally Advanced Rectal Cancer During The COVID-19 Pandemic: A Necessary Paradigm Change at Memorial Sloan Kettering Cancer Center.Adv Radiat Oncol. 2020; 5: 687-689
- An observational study of the demographic and treatment changes in a tertiary colorectal cancer center during the COVID-19 pandemic.J Surg Oncol. 2020; 122: 1271-1275
- Short-course radiotherapy followed by neo-adjuvant chemotherapy in locally advanced rectal cancer--the RAPIDO trial.BMC Cancer. 2013; 13: 279
- Short-course radiotherapy followed by chemotherapy before TME in locally advanced rectal cancer: The randomized RAPIDO trial.J Clin Oncol. 2020; 38: 4006
- Extended Intervals after Neoadjuvant Therapy in Locally Advanced Rectal Cancer: The Key to Improved Tumor Response and Potential Organ Preservation.J Am Coll Surg. 2015; 221: 430-440
- Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial.Lancet Oncol. 2017; 18: 336-346
- Tumour regression in the randomized Stockholm III Trial of radiotherapy regimens for rectal cancer.Br J Surg. 2015; 102 ([discussion: 978]): 972-978
- Randomized clinical trial of short or long interval between neoadjuvant chemoradiotherapy and surgery for rectal cancer.Br J Surg. 2018; 105: 1417-1425
- Radiation dose-response model for locally advanced rectal cancer after preoperative chemoradiation therapy.Int J Radiat Oncol Biol Phys. 2013; 85: 74-80
- Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer.JAMA Oncol. 2018; 4: e180071
- Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiation in patients with locally advanced rectal cancer: Final results of PRODIGE 23 phase III trial, a UNICANCER GI trial.J Clin Oncol. 2020; 38: 4007
- Randomized Phase II Trial of Chemoradiotherapy Plus Induction or Consolidation Chemotherapy as Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: CAO/ARO/AIO-12.J Clin Oncol. 2019; 37: 3212-3222
- Neoadjuvant 5-FU or capecitabine plus radiation with or without oxaliplatin in rectal cancer patients: a phase iii randomized clinical trial.J Natl Cancer Inst. 2015; 107: djv248
- Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study.Lancet. 2018; 391: 2537-2545
- Assessment of Clinical Complete Response After Chemoradiation for Rectal Cancer with Digital Rectal Examination, Endoscopy, and MRI: Selection for Organ-Saving Treatment.Ann Surg Oncol. 2015; 22: 3873-3880
- Organ Preservation in Rectal Cancer.J Gastrointest Surg. 2020; 24: 1880-1888
- Long-Term Patient-Reported Outcomes After High-Dose Chemoradiation Therapy for Nonsurgical Management of Distal Rectal Cancer.Int J Radiat Oncol Biol Phys. 2020; 106: 556-563
- Patient-Reported Bowel Function in Patients With Rectal Cancer Managed by a Watch-and-Wait Strategy After Neoadjuvant Therapy: A Case-Control Study.Dis Colon Rectum. 2020; 63: 897-902
Article info
Publication history
Published online: July 05, 2021
Footnotes
Footnote: This article is based in part on Yuval et al. 2020, J. Gastrointest. Surg. 24:1880–1888.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
