ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2022
Can we Save the rectum by watchful waiting or TransAnal surgery following (chemo)Radiotherapy versus Total mesorectal excision for early REctal Cancer (STAR-TREC)? Protocol for the international, multicentre, rolling phase II/III partially randomized patient preference trial evaluating long-course concurrent chemoradiotherapy versus short-course radiotherapy organ preservation approaches.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
What it found
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Who cites it
30 citing papers in PubMed, 74 citations in OpenAlex.
- Quality-of-life outcomes in older patients with early-stage rectal cancer receiving organ-preserving treatment with hypofractionated short-course radiotherapy followed by transanal endoscopic microsurgery (TREC): non-randomised registry of patients unsuitable for total mesorectal excision.The lancet. Healthy longevity · 2022Trial
- Neoadjuvant Chemoradiotherapy Plus Local Excision vs. Radical Surgery in T1-2N0M0 Rectal Carcinoma: A SEER-based Propensity Matching Study.Journal of gastrointestinal cancer · 2026Article
- Non-operative Management of Rectal Cancer with Adjuvant Chemotherapy after Chemoradiotherapy (NORMANDY): Prospective Study.Cancer research and treatment · 2026Article
- Significance of nodal yield after rectal resection in the TNT era: does count matter?BMC cancer · 2026Article
- Advancing MRI diagnostic practices in rectal cancer: exploring the impact of web-based multi-reader study participation.Abdominal radiology (New York) · 2026Article
- Total neoadjuvant therapy in rectal cancer: The FOREST protocol, a patient-centered approach that clusters two cohorts with different outcomes.International journal of cancer · 2026Article
- Optimising response assessment to neoadjuvant therapy in rectal cancer to reduce the incidence of ypT0N0 resection.International journal of colorectal disease · 2026Article
- Quality of life and functional outcomes after rectal sparing approaches following neoadjuvant therapy for rectal cancer: a prospective cohort multicentre study.International journal of surgery (London, England) · 2025Article
- Pathologic complete response in rectal cancer: advocating for local excision.Annals of coloproctology · 2025Article
- A Review on the Evolving Role of Radiation Therapy in the Treatment of Locally Advanced Rectal Cancer.Current oncology (Toronto, Ont.) · 2025Review
- Implementation of Organ Preservation for Locally Advanced Rectal Cancer in Canada: A National Survey of Clinical Practice.Current oncology (Toronto, Ont.) · 2025Article
- Review
- Review
- Lower early-stage rectal cancer surgical approaches: therapeutic options and cancer biomarker alterations.Frontiers in surgery · 2025Review
- Endoscopic Local Excision (ELE) with Knife-Assisted Resection (KAR) Techniques Followed by Adjuvant Radiotherapy and/or Chemotherapy for Invasive (T1bsm2,3/T2) Early Rectal Cancer: A Multicenter Retrospective Cohort.Journal of clinical medicine · 2024Article
- Neoadjuvant Treatment in Rectal Cancer.South Asian journal of cancer · 2024Review
- Review
- Surgical Outcomes after Radiotherapy in Rectal Cancer.Cancers · 2024Review
- Treatment Options for Distal Rectal Cancer in the Era of Organ Preservation.Current treatment options in oncology · 2024Review
- Transanal minimally invasive surgery (TAMIS) for local excision of benign and malignant rectal neoplasia: a 7-year experience.Langenbeck's archives of surgery · 2024Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
aimOrgan-saving treatment for early-stage rectal cancer can reduce patient-reported side effects compared to standard total mesorectal excision (TME) and preserve quality of life. An optimal strategy for achieving organ preservation and longer-term oncological outcomes are unknown; thus there is a need for high quality trials.
methodCan we Save the rectum by watchful waiting or TransAnal surgery following (chemo)Radiotherapy versus Total mesorectal excision for early REctal Cancer (STAR-TREC) is an international three-arm multicentre, partially randomized controlled trial incorporating an external pilot. In phase III, patients with cT1-3b N0 tumours, ≤40 mm in diameter, who prefer organ preservation are randomized 1:1 between mesorectal long-course chemoradiation versus mesorectal short-course radiotherapy, with selective transanal microsurgery. Patients preferring radical surgery receive TME. STAR-TREC aims to recruit 380 patients to organ preservation and 120 to TME surgery. The primary outcome is the rate of organ preservation at 30 months. Secondary clinician-reported outcomes include acute treatment-related toxicity, rate of non-operative management, non-regrowth pelvic tumour control at 36 months, non-regrowth disease-free survival at 36 months and overall survival at 60 months, and patient-reported toxicity, health-related quality of life at baseline, 12 and 24 months. Exploratory biomarker research uses circulating tumour DNA to predict response and relapse. DISCUSSION: STAR-TREC will prospectively evaluate contrasting therapeutic strategies and implement new measures including a smaller mesorectal target volume, two-step response assessment and non-operative management for complete response. The trial will yield important information to guide routine management of patients with early-stage rectal cancer.
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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.