Neoadjuvant radiotherapy for rectal cancer management.

Neoadjuvant radiotherapy for rectal cancer management. World J Gastroenterol. 2019 Sep 07;25(33):4850-4869 Authors: Feeney G, Sehgal R, Sheehan M, Hogan A, Regan M, Joyce M, Kerin M Abstract Thirty per cent of all colorectal tumours develop in the rectum. The location of the rectum within the bony pelvis and its proximity to vital structures presents significant therapeutic challenges when considering neoadjuvant options and surgical interventions. Most patients with early rectal cancer can be adequately managed by surgery alone. However, a significant proportion of patients with rectal cancer present with locally advanced disease and will potentially benefit from down staging prior to surgery. Neoadjuvant therapy involves a variety of options including radiotherapy, chemotherapy used alone or in combination. Neoadjuvant radiotherapy in rectal cancer has been shown to be effective in reducing tumour burden in advance of curative surgery. The gold standard surgical rectal cancer management aims to achieve surgical removal of the tumour and all draining lymph nodes, within an intact mesorectal package, in order to minimise local recurrence. It is critically important that all rectal cancer cases are discussed at a multidisciplinary meeting represented by all relevant specialties. Pre-operative staging including CT thorax, abdomen, pelvis to assess for distal disease and magnetic resonance imaging to assess local involvement is essential. Staging radiology ...
Source: World Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research

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ConclusionThe highest reliability of identifying best performance based on an outcome was 57%. However, the balance between reliability and relevance of outcomes is vulnerable. No (group of) hospital(s) could be identified as best performer on all outcomes. Performance was not consistent on outcomes.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
ConclusionPerforming a colon conduit in patients undergoing total pelvic exenteration for LARC or LRRC avoids the risks of ileo-ileal anastomotic leakage and may reduce the risk of a post-operative ileus. Besides, there are no other differences in outcome for ileal and colon conduits.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
Conclusion Multiparametric MRI of rectum, using ADC as the diffusion and ktrans as the perfusion parameter is a repeatable technique. This technique may potentially be used in prediction and evaluation of neoadjuvant treatment response. New studies with larger patient groups are needed to validate the role of multiparametric MRI. PMID: 32071023 [PubMed - as supplied by publisher]
Source: Diagnostic and Interventional Radiology : The Turkish Society of Radiology - Category: Radiology Authors: Tags: Diagn Interv Radiol Source Type: research
This article aimed to summarize current status of colorectal cancer (CRC) in Thailand. In brief, CRC is the third most common cancer and accounts for 11% of cancer burden in Thailand. It was the only malignancy with increased incidence in both genders in Thailand. Over 10,000 new CRC cases occurred annually and about 40% were rectal cancer. Due to the lack of CRC screening and public awareness, non-metastatic cancer was accounted only for 20-30% of overall cases. The demand for general or colorectal surgeons outmatches the supply with a ratio of 1 general surgeon to 35,000 individuals. There are about 70 board-certified co...
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
Conclusion: The triple-staple technique is a safe alternative to the double-staple anastomosis after anterior resection. It also effectively shortens the operating time. PMID: 32054240 [PubMed - as supplied by publisher]
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
Traditionally, rectal cancer radiation therapy uses bony landmark fields to cover common lymphatic drainage sites, including the internal iliac, presacral, and perirectal lymph nodes. We aimed to investigate if bony landmark borders sufficiently cover the internal iliac nodes and to compare tumor volume and normal tissue avoidance using classic bony landmarks (c3DCRT), contoured elective clinical target volume (f3DCRT), and volumetric modulated arc therapy (VMAT) planning in locally advanced rectal cancer.
Source: Journal of Medical Imaging and Radiation Sciences - Category: Radiology Authors: Tags: Research Article Source Type: research
No abstract available
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Web-Exclusive Content: Letter to the Editor Source Type: research
No abstract available
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Editorial Source Type: research
CONCLUSIONS: A DNA repair gene score may predict patients likely to have poor response to chemoradiation. This score may be a relevant tool to be investigated in future studies focused on chemoradiation used in the context of organ preservation. See Video Abstract at http://links.lww.com/DCR/B104. PREDICCIÓN DE RESPUESTA DEFICIENTE A LA RADIO-QUIMIOTERAPIA NEOADYUVANTE EN PACIENTES CON CÁNCER RECTAL UTILIZANDO UNA PUNTUACIÓN DE DESREGULACIÓN DE REPARACIÓN DE ADN: ESCOGER LOS PERDEDORES EN LUGAR DE LOS GANADORES ANTECEDENTES: Los pacientes con cáncer rectal pueden someterse a ...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
CONCLUSIONS: Although the whole-body PET/MRI was more accurate than the pelvic MRI alone for the prediction of tumor and node response to preoperative chemoradiotherapy, the technique performed worse than CT in detecting small lung metastasis. See Video Abstract at http://links.lww.com/DCR/B108. TOMOGRAFÍA POR EMISIÓN DE POSITRONES DE 18F- FLUORODEOXIGLUCOSA (FDG) / RESONANCIA MAGNÉTICA (TEP/RM) PARA ESTADIFICACIÓN TUMORAL TNM DE CÁNCER DEL RECTO DESPUÉS DE LA QUIMIORRADIOTERAPIA PREOPERATORIA - EXPERIENCIA INICIAL OBJETIVO: Evaluar el valor de la tomografía por emisi&...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
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