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Tailored rectal cancer treatment – a time for implementing contemporary prognostic factors?
Author(s) -
Wibe A.,
Law W. L.,
Fazio V.,
Delaney C. P.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12317
Subject(s) - medicine , colorectal cancer , guideline , chemoradiotherapy , stage (stratigraphy) , pathological , radiological weapon , disease , cancer , oncology , intensive care medicine , surgery , pathology , biology , paleontology
Aim To report data supporting the development of tailored treatment strategies for rectal cancer. Method A comprehensive review of the literature on the impact of prognostic factors cur‐rently not included in international guidelines in rectal cancer management. Results There is considerable variation in treatment guidelines for rectal cancer worldwide, especially for Stage II and Stage III disease. Long‐term side effects of chemoradiotherapy are not considered in any guideline. Detailed knowledge, and the prognostic impact, of the circumferential resection margin, tumour grade and venous invasion should be factored into the development of a treatment strategy. Conclusion Factors additional to the TNM system should improve decision making for contemporary rectal cancer treatment. Optimized radiological and pathological evaluations, and a focus on detailed clinical factors, should be the basis for treatment decisions. International guidelines should consider all known prognostic factors for long‐term oncological and functional outcomes.