ArticleInternational journal of colorectal disease2016
Local excision of low rectal cancer treated by chemoradiotherapy: is it safe for all patients with suspicion of complete tumor response?
Article in International journal of colorectal disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 12 citations in OpenAlex.
- Endoscopy-Based Deep Convolutional Neural Network Predicts Response to Neoadjuvant Treatment for Locally Advanced Rectal Cancer.Frontiers in physiology · 2022Article
- Preoperative chemoradiotherapy followed by local excision in clinical T2N0 rectal cancer.Radiation oncology journal · 2016Article
- Assessment of clinical and pathological complete response after neoadjuvant chemoradiotherapy in rectal adenocarcinoma and its therapeutic implications.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologieArticle
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Authors and funding
6 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study is to assess if local excision (LE) could be proposed if suspicion of complete tumor response (CR) after neoadjuvant chemoradiotherapy (CRT) for low rectal cancer (LRC) and this despite a potential risk of nodes (N+) or other tumor deposits (OTD) left in place. The aim was to assess in patients with LRC treated by CRT: (a) pathologic results of LE and total mesorectal excision (TME) in case of preoperative suspicion of CR and (b) the risk of N+ or OTD on TME if ypT0-Tis-T1 tumor. PATIENTS: Among 202 patients with LRC after CRT, 33 (16 %) with suspicion of CR underwent LE (n = 20) because of comorbidities and/or indication of definitive stoma or TME (n = 13). Pathologic examination of LE and TME specimens and oncological outcomes were assessed. Furthermore, 40/202 patients with pathologic CR on TME specimen (ypT0-Tis-T1) were assessed for possible N+ or OTD.
resultsIn the 33 patients with suspicion of CR: (a) after LE, tumor was ypT0-Tis-T1 in only 15/20 cases (75 %); (b) after TME, tumor was ypT0-Tis-T1 in only 7/13 cases (54 %). Among 40 patients with ypT0-Tis-T1 tumor on TME specimen, 4 (10 %) presented N+ and/or OTD.
conclusionIn LRC with suspicion of CR after CRT, LE deserves a word of caution: 25 % of patients have in fact ypT2-T3 tumors. Furthermore, in patients with ypT0-Tis or T1 on TME specimen, a 10 % risk of N+ and/or ODT is observed. Thus, patient with suspicion of CR after CRT and treated by LE is exposed to a possible incomplete oncologic treatment.
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