Preoperative Radiotherapy Combined with Total Mesorectal Excision for Resectable Rectal Cancer

Kapiteijn, Ellen; Marijnen, Corrie A.M.; Nagtegaal, Irıs D.; Putter, Hein; Steup, W. H.; Wiggers, Theo; Rutten, H.J.T.; Påhlman, Lars; Glimelius, Bengt; Krieken, J. Han J.M. van; Leer, J.W.H.; Velde, Cornelis J.H. van de

doi:10.1056/nejmoa010580

Cited by 3,790 publications

(2,413 citation statements)

References 26 publications

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Section: Discussionmentioning

confidence: 99%

“…Since 2001, the total mesorectal excision technique became the standard for rectal cancer surgery in the Netherlands and contributed to an improved survival 7, 28. Simultaneously, preoperative (chemo)radiotherapy was implemented in the treatment for Stage II/III rectal cancer in the Netherlands 7. The addition of preoperative (chemo)radiotherapy has not demonstrated an overall survival benefit in randomized trials, although a more tailored application for high‐risk groups might impact survival based on subgroup analysis 29…”

Section: Discussionmentioning

confidence: 99%

“…CT scanning has become standard for staging with the addition of MRI in rectal cancer patients 5. Improved surgical techniques as well as subspecialization substantially contributed to the quality of oncological treatment, besides reducing morbidity 6, 7, 8. Preoperative radiotherapy options have increased with several new schedules combining this modality with systemic treatment as induction, concomitant or consolidation therapy 9, 10.…”

Section: Introductionmentioning

confidence: 99%

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An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Brouwer

Bos

Lemmens

et al. 2018

Intl Journal of Cancer

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233

193

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Regarding the continuous changes in the diagnostic process and treatment of colorectal cancer (CRC), it is important to evaluate long‐term trends which are relevant in giving direction for further research and innovations in cancer patient care. The aim of this study was to analyze developments in incidence, treatment and survival for patients diagnosed with CRC in the Netherlands. For this population‐based retrospective cohort study, all patients diagnosed with CRC between 1989 and 2014 in the Netherlands were identified using data of the nationwide population‐based Netherlands Cancer Registry (n = 267,765), with follow‐up until January 1, 2016. Analyses were performed for trends in incidence, mortality, stage distribution, treatment and relative survival measured from the time of diagnosis. The incidence of both colon and rectal cancer has risen. The use of postoperative chemotherapy for Stage III colon cancer increased (14–60%), as well as the use of preoperative (chemo)radiotherapy for rectal cancer (2–66%). The administration of systemic therapy and metastasectomy increased for Stage IV disease patients. The 5‐year relative survival increased significantly from 53 to 62% for colon cancer and from 51 to 65% for rectal cancer. Ongoing advancements in treatment, and also improvement in other factors in the care of CRC patients—such as diagnostics, dedicated surgery and pre‐ and postoperative care—lead to a continuous improvement in the relative survival of CRC patients. The increasing incidence of CRC favors the implementation of the screening program, of which the effects should be monitored closely.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Brouwer

Bos

Lemmens

et al. 2018

Intl Journal of Cancer

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233

193

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“…The rate of LR after ISR varies from 0% to 22.7%, lower than that after APR (10–57%) for mid or low rectal cancer 27, 31, 67. Neoadjuvant CRT affects the down‐sizing of tumor and down‐staging of disease, and is often used as a standard strategy to avoid a positive CRM and LR in rectal cancer patients 68, 69, 70, 71, 72. However, some questions remain as to whether neoadjuvant CRT should be more widely applied for patients who would undergo ISR.…”

Section: Discussionmentioning

confidence: 99%

“…However, some questions remain as to whether neoadjuvant CRT should be more widely applied for patients who would undergo ISR. CRT is associated with higher surgical complications,68, 69 a negative impact on anal function,45, 70 and sexual disorder,71 and has no clear survival benefit 72. In Japan, preoperative neoadjuvant CRT has not been routinely carried out for resectable T1, T2 and T3 tumors regardless of the presence or absence of lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Shirouzu

Murakami

Akagi

2017

Annals of Gastroent Surgery

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Intersphincteric resection (ISR) has rapidly increased worldwide including laparoscopic surgery. However, there are some concerns for the definition of ISR, surgical technique, oncological outcome, anal function, and quality of life (QoL). The aim of the present study is to evaluate those issues. A review of this surgical technique was carried out by searching English language literature of the PubMed online database and appropriate articles were identified. With regard to open‐ISR, the morbidity rate ranged from 7.5% to 38.3%, with lower mortality rates. Local recurrence rates varied widely from 0% to 22.7%, with a mean follow‐up duration of 40–94 months. Disease‐free and overall 5‐year survival rates were 68–86% and 76–97%, respectively. Those outcomes were equivalent to laparoscopic‐ISR. Surgical and oncological outcomes of ISR were generally acceptable. However, accurate evaluation of anal function and QoL was difficult because of a lack of standard assessment of various patient‐related factors. The surgical and oncological outcomes after ISR seem to be acceptable. The ISR technique seems to be valid as an alternative to abdominoperineal resection in selected patients with a very low rectal cancer. However, both necessity for ISR and expectations of QoL impairment as a result of functional disorder should be fully discussed with patients before surgery.

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Induction Chemoradiation for Rectal Cancer

Han

Galandiuk²

2006

Arch Surg

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To review the application, outcome, and recent developments of neoadjuvant chemoradiation therapy with respect to rectal cancer. Data Sources and Study Selection: Articles written in English after 1980 selected from MEDLINE and PubMed from the National Library of Medicine. Case reports were excluded. There were no other criteria for exclusion of published information pertaining to this topic. Data Extraction and Synthesis: Articles were obtained and organized from MEDLINE and PubMed as well as the reference lists of pertinent literature. Conclusions: Published reports have demonstrated that neoadjuvant chemoradiation improves survival and decreases local recurrence in patients with stage II and III rectal cancers. It is anticipated that advances and technical developments in both chemotherapy and radiation therapy will lead to improved oncologic results with decreased toxic side effects.

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Preoperative Radiotherapy Combined with Total Mesorectal Excision for Resectable Rectal Cancer

Abstract: Short-term preoperative radiotherapy reduces the risk of local recurrence in patients with rectal cancer who undergo a standardized total mesorectal excision.

Cited by 3,790 publications

References 26 publications

An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Induction Chemoradiation for Rectal Cancer

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