Local versus radical surgery for early rectal cancer with or without neoadjuvant or adjuvant therapy

Borao, Elena; Ramı́rez, José M.; Gracia, Juan Antonio Frago; Aguilella, V.; Martínez, Mariano; Maeso, Sergio; Callejo, Daniel; López‐Alcalde, Jesús

doi:10.1002/14651858.cd002198.pub2

Cited by 3 publications

(2 citation statements)

References 52 publications

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“…Quality-of-life outcomes, although important for all cancer patients, are especially poignant for those navigating the treatment of rectal cancer. Oftentimes, patients will favor organ-preserving therapy to avoid a permanent stoma and sexual function consequences of pelvic surgery or to enjoy improved bowel function and a better quality of life 31 . One study followed patients' Wexner continence score for 60 months after TEM alone and found no long-term effect on anorectal function or quality of life.…”

Section: Quality Of Life and Toxicity Profilesmentioning

confidence: 99%

“…Oftentimes, patients will favor organ-preserving therapy to avoid a permanent stoma and sexual function consequences of pelvic surgery or to enjoy improved bowel function and a better quality of life. 31 One study followed patients' Wexner continence score for 60 months after TEM alone and found no long-term effect on anorectal function or quality of life. These patients did have urgency and an increase in Wexner continence score initially, but this declined within 12 months and returned to normal by the end of the study period at 5 years.…”

Section: Quality Of Life and Toxicity Profilesmentioning

confidence: 99%

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Local Excision for Early-Stage Rectal Adenocarcinomas

Donohue,

Rossi,

Deek

et al. 2024

Cancer J

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Although total mesorectal excision (TME) remains the standard of care for rectal cancer, including early-stage T1/T2 rectal adenocarcinoma, local excision may be warranted for these early-stage tumors in a select group of patients who may decline surgery or may be nonoptimal surgical candidates. Operative approaches for transanal local excision include transanal endoscopic microsurgery or transanal minimally invasive surgery for tumors <4 cm, occupying <40% of the rectal circumference and <10 cm from the dentate line. The use of preoperative chemoradiation therapy may help to downstage tumors and allow for more limited resections, and chemoradiation may also be employed postoperatively. Local excision approaches appear to result in improved quality of life compared with TME, but limited resections may also compromise survival rates compared with TME. Multidisciplinary management and shared decision-making can allow for the desired patient outcomes.

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Section: Quality Of Life and Toxicity Profilesmentioning

confidence: 99%

Section: Quality Of Life and Toxicity Profilesmentioning

confidence: 99%