Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Dec 27;7(2):198-215.
doi: 10.1002/ags3.12646. eCollection 2023 Mar.

Essential updates 2020/2021: Advancing precision medicine for comprehensive rectal cancer treatment

Ichiro Takemasa  1 , Atsushi Hamabe  1   2 , Masaaki Miyo  1 , Emi Akizuki  1 , Koichi Okuya  1
Affiliations
Review

Essential updates 2020/2021: Advancing precision medicine for comprehensive rectal cancer treatment

Ichiro Takemasa et al. Ann Gastroenterol Surg. .

Abstract

In the paradigm shift related to rectal cancer treatment, we have to understand a variety of new emerging topics to provide appropriate treatment for individual patients as precision medicine. However, information on surgery, genomic medicine, and pharmacotherapy is highly specialized and subdivided, creating a barrier to achieving thorough knowledge. In this review, we summarize the perspective for rectal cancer treatment and management from the current standard-of-care to the latest findings to help optimize treatment strategy.

Keywords: diagnosis; multimodal therapy; rectal cancer; stratification; surgery.

PubMed Disclaimer

Conflict of interest statement

The other authors declare no conflicts of interest. Ichiro Takemasa is the editorial member of the Annals of Gastroenterologial Surgery.

Figures

FIGURE 1
FIGURE 1
Semiopened circular specimen processing method for pathological circumferential resection margin (CRM) assessment (a) anterior view of the resected rectal specimen. (b) Semiopened rectal specimen. (c) Axial section of rectal cancer on MRI. (d) Transverse section of the semiopened rectal specimen. (e) Hematoxylin and eosin staining of the transverse section, allowing a comparison of the pathological CRM and preoperative mesorectal fascia (MRF) involvement
FIGURE 2
FIGURE 2
Intraoperative images during transanal total mesorectal excision (TME) and transperineal abdominoperineal excision (APE) (a) dissection of the rectourethral muscle and (b) exposure of pelvic splanchnic nerve S4 in transanal TME. (c) Dissection of the rectourethral muscle and (d) surgical view seen from the perineal side after rectal resection in transperineal APE. ‡rectourethral muscle, †pelvic splanchnic nerve S4, §prostate, #urethra
FIGURE 3
FIGURE 3
Evaluation of vascular perfusion using indocyanine green (ICG) fluorescence angiography. View with near‐infrared (NIR) light before (a) and after (b) ICG injection. Vascular perfusion was considered good when it was well visualized within 60 s
FIGURE 4
FIGURE 4
Fluorescence‐guided total mesorectal excision. Indocyanine green fluorescence overlaid on a white light image enables real‐time visualization of lymphatic flow. The mesorectal fascia enveloping the lymph flows and nodes as an intact package can be recognized during surgery for rectal cancer
See this image and copyright information in PMC

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. - PubMed
    1. Glynne‐Jones R, Wyrwicz L, Tiret E, Brown G, Rödel C, Cervantes A, et al. Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow‐up†. Ann Oncol. 2017;28(suppl_4):iv22–40. - PubMed
    1. Benson A. NCCN guideline<rectal‐2.pdf>. 2022.
    1. Colon Cancer Laparoscopic or Open Resection Study G , Buunen M, Veldkamp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long‐term outcome of a randomised clinical trial. Lancet Oncol. 2009;10(1):44–52. - PubMed
    1. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AMH, et al. Short‐term endpoints of conventional versus laparoscopic‐assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–26. - PubMed