ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2006
Patterns of failure and survival for nonoperative treatment of stage c0 distal rectal cancer following neoadjuvant chemoradiation therapy.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 115 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diagnostic Value of Novel MR Imaging Techniques for the Primary Staging and Restaging of Rectal Cancer
Follow up and Functional Outcome of Organ Saving Treatment in Patients With Good Response to Neo-adjuvant (Chemo)Radiation for Rectal Cancer
Radical External Beam Chemoradiation in Patients With Rectal Cancer: a "Wait-and-see" Approach
MRI for Response Evaluation After Chemoradiation for Locally Advanced Rectal Cancer
Chemotherapy Combined With High-dose Radiotherapy for Low Rectal Cancer Using Magnetic Resonance Guided Radiotherapy Linear Accelerator：A Prospective Phase 2 Trial
Organ Preservation in Rectal Adenocarcinoma Using Hypofractionated Pelvic Radiotherapy (Hypo-OPRA): A Phase II Clinical Trial
Who cites it
115 citing papers in PubMed, 5 syntheses or guidelines pooled it, 384 citations in OpenAlex.
- Induction chemotherapy followed by neoadjuvant chemoradiotherapy and surgery for patients with locally advanced rectal cancer: a systematic review and meta-analysis.International journal of colorectal disease · 2020Pooled it
- Systematic review and meta-analysis on outcomes of salvage therapy in patients with tumour recurrence during 'watch and wait' in rectal cancer.Annals of the Royal College of Surgeons of England · 2019Pooled it
- Systematic review of treatment intensification using novel agents for chemoradiotherapy in rectal cancer.The British journal of surgery · 2018Pooled it
- Pooled it
- Oncological outcomes of local excision compared with radical surgery after neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and meta-analysis.International journal of colorectal disease · 2015Pooled it
- Effect of interval between preoperative radiotherapy and surgery on clinical outcome and radiation proctitis in rectal cancer from FOWARC trial.Cancer medicine · 2020Trial
- Value of ADC measurements for nodal staging after chemoradiation in locally advanced rectal cancer-a per lesion validation study.European radiology · 2011Trial
- Total Neoadjuvant Therapy Versus Long-Course Chemoradiotherapy in Locally Advanced Rectal Cancer: Real-World Tumor Response and Clinical Outcomes.Medical sciences (Basel, Switzerland) · 2026Article
- Article
- A Review on the Evolving Role of Radiation Therapy in the Treatment of Locally Advanced Rectal Cancer.Current oncology (Toronto, Ont.) · 2025Review
- A randomized phase II/III trial of rosuvastatin with neoadjuvant chemo-radiation in patients with locally advanced rectal cancer.Frontiers in oncology · 2025Article
- Neoadjuvant Treatment in Rectal Cancer.South Asian journal of cancer · 2024Review
- Neoadjuvant treatment of rectal cancer: Where we are and where we are going.World journal of clinical oncology · 2024Article
- Outcome of Patients with Locally Advanced Rectal Cancer Pursuing Non-Surgical Strategy in National Cancer Database.Cancers · 2024Article
- A study on the radiomic correlation between CBCT and pCT scans based on modified 3D-RUnet image segmentation.Frontiers in oncology · 2024Article
- Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case series.Frontiers in immunology · 2024Article
- Nonoperative management of rectal cancer.Frontiers in oncology · 2024Review
- Personalized medicine for locally advanced rectal cancer: five years of complete clinical response after neoadjuvant radiochemotherapy-a case report with a literature review.Frontiers in surgery · 2024Article
- High-dose rate endorectal brachytherapy for rectal cancer: A state-of-the-art review.Cancer science · 2023Review
- Individualizing multi-modality therapy for locally advanced rectal cancer: incorporating new data into practice.ESMO gastrointestinal oncology · 2023Review
55 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Neoadjuvant chemoradiation therapy (CRT) is the preferred treatment option for distal rectal cancer. Complete pathological response after CRT has led to the proposal of nonoperative approach as an alternative treatment for highly selected patients with complete clinical response. However, patterns of failure following this strategy remains undetermined. Three hundred sixty-one patients with distal rectal cancer were managed by neoadjuvant CRT including 5-FU, leucovorin, and 5040 cGy. Tumor response assessment was performed at 8 weeks following CRT. Patients with complete clinical response were not immediately operated on and were closely followed. One hundred twenty-two patients were considered to have complete clinical response after the first tumor response assessment. Of these, only 99 patients sustained complete clinical response for at least 12 months and were considered stage c0 (27.4%) and managed nonoperatively. Mean follow-up was 59.9 months. There were 13 (13.1%) recurrences: 5 (5%) endorectal, 7 (7.1%) systemic, and 1 (1%) combined recurrence. All 5 isolated endorectal recurrences were salvaged. Mean recurrence interval was 52 months for local failure and 29.5 months for systemic failure. There were five cancer-related deaths after systemic recurrences. Overall and disease-free 5-year survivals were 93% and 85%. Even though surgery remains the standard treatment for rectal cancer, nonoperative treatment after complete clinical response following neoadjuvant CRT may be safe and associated with good survival rates in a highly selected group of patients. Survival in these patients is significantly affected by systemic failure. Exclusive local failure occurs late after CRT completion and is frequently amenable to salvage therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.