Open AccessAdvances in the treatment of locally advanced rectal cancer
Author(s) -
Ali Fadwa,
Keshinro Ajaratu,
Weiser Martin R.
Publication year - 2021
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12389
Subject(s) - medicine , total mesorectal excision , colorectal cancer , radiation therapy , multidisciplinary approach , chemotherapy , neoadjuvant therapy , risk stratification , general surgery , chemoradiotherapy , oncology , surgery , cancer , social science , sociology , breast cancer
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.