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Meta-Analysis
. 2013;18(7):833-42.
doi: 10.1634/theoncologist.2013-0022. Epub 2013 Jul 2.

Selecting patients with locally advanced rectal cancer for neoadjuvant treatment strategies

Alice Dewdney  1 , David Cunningham, Ian Chau
Affiliations
Meta-Analysis

Selecting patients with locally advanced rectal cancer for neoadjuvant treatment strategies

Alice Dewdney et al. Oncologist. 2013.

Abstract

Rectal cancer remains a significant problem worldwide. Outcomes vary significantly according to the stage of disease and prognostic factors, including the distance of the tumor from the circumferential resection margin. Accurate staging, including high-resolution magnetic resonance imaging, allows stratification of patients into low-, moderate-, and high-risk disease; this information can be used to inform multidisciplinary team decisions regarding the role of neoadjuvant therapy. Both neoadjuvant short-course radiotherapy and long-course chemoradiation reduce the risk of local recurrence compared with surgery alone, but they have little impact on survival. Although there remains a need to reduce overtreatment of those patients at moderate risk, evaluation of intensified regimens for those with high-risk disease is still required to reduce distant failure rates and improve survival in these patients with an otherwise poor prognosis.

Keywords: Chemoradiation; Magnetic resonance imaging; Neoadjuvant treatment; Rectal cancer.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

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