Local Resection of Rectal Cancer after Neoadjuvant Therapy: A New Trend for Organ Preservation

Abstract

Low anterior resection for rectal cancer is associated with high morbidity, permanent stomas and functional impairment. Different strategies to avoid this surgery in low rectal cancer are being pursued. Several prospective trials have explored a strategy of neoadjuvant treatment to downstage rectal cancer and allow for local resection of the tumor. In this paper we review these trials and the published results of this strategy in regards of patient selection, successful downstaging, oncologic outcomes, morbidity and functional outcomes. In selected patients, this new strategy achieved good downstaging of tumors and similar oncologic outcomes when compared to radical resection. Some questions regarding patient selection remain, mainly which patients should undergo completion surgery after local resection.