Current Status of the Management of Stage I Rectal Cancer

AbstractPurpose of ReviewTo summarize the current available treatments for stage I rectal cancer and the evidence that supports them.Recent FindingsRadical surgery, or total mesorectal excision (TME) without neoadjuvant therapy, reports excellent oncologic outcomes, with 5-year disease-free survival of approximately 95%. Alternative therapies include local excision, which has acceptable long-term outcomes in some low-risk T1 tumors; but overall local excision, with or without additional chemotherapy or radiation, generally reports 5-year disease-free survival less than TME alone. New research is showing complete clinical response rates of 67% with chemoradiation combined with additional consolidation chemotherapy in T2 lesions, making watch and wait a potential strategy for stage I tumors.SummaryOwing to its superior oncologic outcomes, radical surgery remains the mainstay of treatment for stage I tumors. Both local excision and watch and wait have advantages that may make them useful in individual patients and should be considered under the right circumstances.
Source: Current Oncology Reports - Category: Cancer & Oncology Source Type: research

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Condition:   Rectal Cancer Interventions:   Drug: TAS 102;   Drug: Oxaliplatin Sponsors:   Benaroya Research Institute;   Virginia Mason Hospital/Medical Center Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionsThe incline angle of pelvic floor muscle is an independent predictor of surgical duration. In patients with steeper incline of PFM, transabdominal TME is expected to be difficult. This index is novel, but needs to be further validated.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionsThis series is the largest to report that simultaneous curative-intent management of synchronous PC and RC is feasible and safe. Pelvic exenteration might be a better option when RC complete resection seems not achievable through TME.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
ConclusionRadiomics of pretreatment MRIs can predict pCR, TRG, and NAR score in patients with LARC undergoing neoadjuvant treatment and TME with moderate accuracy despite extremely heterogenous image data. Both the tumor and MC contain important prognostic information.Key Points• Machine learning of rectal cancer on images from the pretreatment MRI can predict important patient outcomes with moderate accuracy.• The tumor and the tissue around it both contain important prognostic information.
Source: European Radiology - Category: Radiology Source Type: research
This randomized clinical trial compares 30-day postoperative and 1-year follow-up results of Turnbull-Cutait pull-through hand-sewn coloanal anastomosis and standard hand-sewn coloanal anastomosis after ultralow rectal resection for rectal cancer.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
In the study by Biondo et al in this issue of JAMA Surgery, although 30-day postoperative morbidity was similar between the Turnbull-Cutait pull-through procedure with 2-stage hand-sewn coloanal anastomosis (TCA) and a standard hand-sewn coloanal anastomosis and diverting loop ileostomy (CAA/DLI), the anastomotic leak rate was 24% vs 13% for the CAA/DLI and TCA groups, respectively, suggesting a possible trend toward superiority of TCA over CAA/DLI in terms of anastomotic leakage. This is consistent with systematic reviews. Of note, the anastomotic leak rate may be further lowered following a TCA by delaying the hand-sewn ...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
ConclusionCompared to MPLS, RPLS provides several advantages for the treatment of URC among elderly individuals, including a shorter length of surgical incision, reduced postoperative pain, shorter time to first flatus after surgery, earlier mobilization, and better cosmetic outcomes. These advantages are achieved with no difference in the length of surgery, nor in the 3 ‐year disease‐free and overall survival rate, compared to MPLS.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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