Neoadjuvant Chemotherapy without Radiation in Colorectal Cancer

Clin Colon Rectal Surg DOI: 10.1055/s-0040-1713746In colon cancer, primary surgery followed by postoperative chemotherapy represents the standard of care. In rectal cancer, the standard of care is preoperative radiotherapy or chemoradiation, which significantly reduces local recurrence but has no impact on subsequent metastatic disease or overall survival. The administration of neoadjuvant chemotherapy (NACT) before surgery can increase the chance of a curative resection and improves long-term outcomes in patients with liver metastases. Hence, NACT is being explored in both primary rectal and colon cancers as an alternative strategy to shrink the tumor, facilitate a curative resection, and simultaneously counter the risk of metastases. Yet, this lack of clarity regarding the precise aims of NACT (downstaging, maximizing response, or improving survival) is hindering progress. The appropriate cytotoxic agents, the optimal regimen, the number of cycles, or duration of NACT prior to surgery or in the postoperative setting remains undefined. Several potential strategies for integrating NACT are discussed with their advantages and disadvantages. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Clinics in Colon and Rectal Surgery - Category: Surgery Authors: Tags: Review Article Source Type: research

Related Links:

Publication date: December 2020Source: Cancer Epidemiology, Volume 69Author(s): Rita Peila, Rhonda S. Arthur, Thomas E. Rohan
Source: Cancer Epidemiology - Category: Cancer & Oncology Source Type: research
ConclusionThis study suggests that multidisciplinary management is a potentially effective treatment strategy for isolated LNM. Since time to LNM, the T-stage, and histological type are prognostic factors, an active follow-up program for colorectal cancer is required.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionsApplication of pure transanal endoscopic colectomy without abdominal assistance to ACC appears to be feasible and safe.
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
In this study, we used real-time polymerase chain reaction to examine the expressions of miR-302a, miR-105, and miR-888 in normal mucosa and cancer tissue from rectal cancer patients with and without preoperative RT. The biological function of miR-302a, miR-105, and miR-888 expression was further analyzed and identified through the public databases: TCGA (The Cancer Genome Atlas) and GEPIA (Gene Expression Profiling Interactive Analysis). The results showed that the expression of miR-105 in rectal cancer was higher than that in normal mucosa in RT (P = 0.042) and non-RT patients (P = 0.003) and was associated with mucinous...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: Although the uptake and timeliness of chemotherapy for colorectal cancer has been improving, Māori, Pacific, Asian and older patients were less likely to receive chemotherapy and less likely to receive chemotherapy in a timely manner. There is a variation in use of chemotherapy by Region with patients in the Southern Cancer region appearing to be the most likely to receive chemotherapy and to receive it within a timely period. PMID: 32994590 [PubMed - in process]
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
Operation is the standard of care after neoadjuvant chemoradioterapy. Therefore a nonoperative management (W&W) has been proposed as an option for patients who achieve a complete clinical response by exclusive chemoradiotherapy. This approach is still investigational and we compared outcomes between patients in this group with those who had a complete pathologic response after surgical resection to address whether W&W approach has an oncologic efficacy in terms of overall survival, disease-free survival, local relapse, and distant relapse, and also whether it should be implemented in clinical practice.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Colon and rectal surgery Source Type: research
Since its introduction in the early 1980s, Trans-anal Endoscopic Microsurgery (TEM) has become the standard treatment for benign rectal lesions not amenable to endoscopic excision and for low risk early rectal cancers. In 2010 Trans Anal Minimal Invasive Surgery (TAMIS), which uses a disposable platform, was introduced to simplify the technique and to increase its popularity. The aim of the present study was to compare TEM and TAMIS in terms of incidence of R1 resection, fragmentation, perioperative operative complication.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Colon and Rectal Surgery Source Type: research
Neoadjuvant chemoradiotherapy has become the standard treatment for locally advanced rectal cancer. Watchful waiting (WW) strategy was used in a few patients with clinical complete response (cCR).
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Colon and Rectal Surgery Source Type: research
Palliative care may play a role in the management of stage IV rectal adenocarcinoma, but its use among this population is not well studied.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Colon and Rectal Surgery Source Type: research
Previous studies have shown high rates of positive circumferential resection margin (CRM) after proctectomy in the US. We sought to explore whether widespread deployment of neoadjuvant therapy has impacted the national rate of positive CRM.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Colon and Rectal Surgery Source Type: research
More News: Cancer | Cancer & Oncology | Chemotherapy | Colon Cancer | Colorectal Cancer | Liver | Neoadjuvant Chemotherapy Therapy | Neoadjuvant Radiation Therapy | Neoadjuvant Therapy | Rectal Cancers | Surgery | Urology & Nephrology