PURPOSE: Many considerations, such as morbidity, sexual and urinary dysfunction, or risk of definitive stoma have led to the increased popularity of local therapy in the therapeutic strategy for rectal cancer. However, its role in curative intent is still controversial with oncologic long-term results lower than those obtained by radical surgery. METHODS: MEDLINE, EMBASE, LILACS, Abstract books, and reference lists from reviews were searched with English language publications to review the current status of evidence for local therapy in rectal cancer, looking especially at the oncologic results and patient selection. We have focused on the new strategies combining neoadjuvant and adjuvant treatment to explain their place in the management of rectal cancer. RESULTS AND CONCLUSIONS: The key to potentially curative local treatment for rectal cancer is patient selection by identifying the best candidates with preoperative tumor staging and clinical and pathologic assessment of favorable features. Low-risk T1 is suitable for local excision alone. Limited data suggest that adjuvant chemoradiotherapy may be helpful in patients with unfavorable T1 and T2 lesions, achieving a local recurrence rate<20 percent. However, the efficacy of salvage surgery after local excision is uncertain.
PURPOSE: Many considerations, such as morbidity, sexual and urinary dysfunction, or risk of definitive stoma have led to the increased popularity of local therapy in the therapeutic strategy for rectal cancer. However, its role in curative intent is still controversial with oncologic long-term results lower than those obtained by radical surgery. METHODS: MEDLINE, EMBASE, LILACS, Abstract books, and reference lists from reviews were searched with English language publications to review the current status of evidence for local therapy in rectal cancer, looking especially at the oncologic results and patient selection. We have focused on the new strategies combining neoadjuvant and adjuvant treatment to explain their place in the management of rectal cancer. RESULTS AND CONCLUSIONS: The key to potentially curative local treatment for rectal cancer is patient selection by identifying the best candidates with preoperative tumor staging and clinical and pathologic assessment of favorable features. Low-risk T1 is suitable for local excision alone. Limited data suggest that adjuvant chemoradiotherapy may be helpful in patients with unfavorable T1 and T2 lesions, achieving a local recurrence rate<20 percent. However, the efficacy of salvage surgery after local excision is uncertain.
Authors: Jose M Ramirez; Vicente Aguilella; Javier Valencia; Javier Ortego; Jose A Gracia; Pilar Escudero; Ricardo Esco; Mariano Martinez Journal: Int J Colorectal Dis Date: 2011-01-27 Impact factor: 2.571
Authors: Jeonghee Han; Gyoung Tae Noh; Chinock Cheong; Min Soo Cho; Hyuk Hur; Byung Soh Min; Kang Young Lee; Nam Kyu Kim Journal: World J Surg Date: 2017-09 Impact factor: 3.352
Authors: Rory P Kennelly; Anna Heeney; Anne White; David Fennelly; Kieran Sheahan; John M P Hyland; P Ronan O'Connell; Desmond C Winter Journal: Int J Colorectal Dis Date: 2011-12-17 Impact factor: 2.571
Authors: Mario Morino; Mauro Risio; Simon Bach; Regina Beets-Tan; Krzysztof Bujko; Yves Panis; Philip Quirke; Bjorn Rembacken; Eric Rullier; Yutaka Saito; Tonia Young-Fadok; Marco Ettore Allaix Journal: Surg Endosc Date: 2015-01-22 Impact factor: 4.584