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Review
. 2020 Aug 30;5(1):32-38.
doi: 10.1002/ags3.12389. eCollection 2021 Jan.

Advances in the treatment of locally advanced rectal cancer

Fadwa Ali  1 , Ajaratu Keshinro  1 , Martin R Weiser  1
Affiliations
Review

Advances in the treatment of locally advanced rectal cancer

Fadwa Ali et al. Ann Gastroenterol Surg. .

Abstract

Locally advanced rectal cancer requires multidisciplinary care. In the United States, most patients are treated with neoadjuvant chemoradiation delivered over 25-28 days, total mesorectal excision, and 4 months of adjuvant chemotherapy. While effective, this trimodal approach is arduous. Alternative approaches have emerged to streamline treatment without sacrificing oncologic outcomes. These approaches include preoperative chemotherapy with selective use of radiation, short-course radiotherapy delivered over 5 days, and total neoadjuvant therapy with attempted nonoperative organ-preserving management (watch and wait). Ongoing trials are assessing the efficacies of these approaches in combination with various risk stratification strategies.

Keywords: locally advanced rectal cancer; nonoperative management; total mesorectal excision; total neoadjuvant therapy; watch and wait.

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Conflict of interest statement

Funding: John and Michelle Martello Research Fund. Conflict of Interest: None of the authors had a conflict of interest.

References

    1. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F, et al. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66:683–91. - PubMed
    1. Salem ME, Hartley M, Unger K, Marshall JL. Neoadjuvant combined‐modality therapy for locally advanced rectal cancer and its future direction. Oncology (Williston Park). 2016;30:546–62. - PubMed
    1. Nacion A, Park Y, Kim N. Contemporary management of locally advanced rectal cancer: resolving issues, controversies and shifting paradigms. Chin J Cancer Res. 2018;30(1):131–46. - PMC - PubMed
    1. Smith JJ, Garcia‐Aguilar J. Advances and challenges in treatment of locally advanced rectal cancer. J Clin Oncol. 2015;33:1797–808. - PMC - PubMed
    1. Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;1:1479–82. - PubMed