Oncological outcome after MRI‐based selection for neoadjuvant chemoradiotherapy in the OCUM Rectal Cancer Trial. BJS 2018; 105: 1519-1529.
Published: 9th May 2018
Authors: R. Ruppert, T. Junginger, H. Ptok, J. Strassburg, C. A. Maurer, P. Brosi et al.
It is not clear whether all patients with rectal cancer need chemoradiotherapy. A restrictive use of neoadjuvant chemoradiotherapy (nCRT) based on MRI findings for rectal cancer was investigated in this study.
This prospective multicentre observational study included patients with stage cT2–4 rectal cancer, with any cN and cM0 status. Carcinomas in the middle and lower third that were 1 mm or less from the mesorectal fascia, all cT4 tumours, and all cT3 tumours of the lower third were classified as high risk, and these patients received nCRT followed by total mesorectal excision (TME). All other carcinomas with a minimum distance of more than 1 mm from the mesorectal fascia and those in the upper third were classified as low risk; these patients underwent TME alone (no nCRT). Patients were followed for at least 3 years. Outcomes were the rates of local recurrence, distant metastasis and survival.
Among 545 patients included, 428 were treated according to the study protocol: 254 (59·3 per cent) had TME alone and 174 (40·7 per cent) received nCRT and TME. Median follow‐up was 60 months. The 3‐ and 5‐year local recurrence rates were 1·3 and 2·7 per cent respectively, with no differences between the two treatment protocols. Patients with disease requiring nCRT had higher 3‐ and 5‐year rates of distant metastasis (17·3 and 24·9 per cent respectively
Restriction of nCRT to high‐risk patients achieved good results.Full text
You may also be interested in
Authors: R. L. Venchiarutti, M. J. Solomon, C. E. Koh, J. M. Young, D. Steffens
Meta‐analysis of the role of colonoscopy after an episode of left‐sided acute diverticulitis. BJS 2019; 106: 988-997.
Authors: S. J. Rottier, S. T. Dijk, A. A. W. Geloven, W. H. Schreurs, W. A. Draaisma, W. A. Enst et al.
Randomized clinical trial
Multicentre randomized clinical trial of colonic J pouch or straight stapled colorectal reconstruction after low anterior resection for rectal cancer.
Authors: S. Pucciarelli, P. Del Bianco, U. Pace, F. Bianco, A. Restivo, I. Maretto et al.
Authors: T. O. Sillo, A. D. Beggs, D. G. Morton, G. Middleton
Meta‐analysis of the effect of extending the interval after long‐course chemoradiotherapy before surgery in locally advanced rectal cancer.
Authors: É. J. Ryan, D. P. O'Sullivan, M. E. Kelly, A. Z. Syed, P. C. Neary, P. R. O'Connell et al.
Randomized clinical trial
Randomized clinical trial of accelerated enhanced recovery after minimally invasive colorectal cancer surgery (RecoverMI trial).
Authors: B. K. Bednarski, T. P. Nickerson, Y. N. You, C. A. Messick, B. Speer, V. Gottumukkala et al.
Postoperative complications in relation to overall treatment time in patients with rectal cancer receiving neoadjuvant radiotherapy.
Authors: J. Erlandsson, D. Pettersson, B. Glimelius, T. Holm, A. Martling
Organoids from colorectal peritoneal metastases as a platform for improving hyperthermic intraperitoneal chemotherapy.
Authors: I. Ubink, A. C. F. Bolhaqueiro, S. G. Elias, D. A. E. Raats, A. Constantinides, N. A. Peters et al.
Immunogenomic profiles associated with response to neoadjuvant chemoradiotherapy in patients with rectal cancer.
Authors: T. Akiyoshi, N. Tanaka, K. Kiyotani, O. Gotoh, N. Yamamoto, K. Oba et al.
BRAF mutation is not associated with an increased risk of recurrence in patients undergoing resection of colorectal liver metastases.
Authors: J.‐B. Bachet, N. Moreno‐Lopez, L. Vigano, U. Marchese, M. Gelli, L. Raoux et al.
Systematic review of outcomes after total neoadjuvant therapy for locally advanced rectal cancer. BJS 2019; 106: 979-987.
Authors: A. Zaborowski, A. Stakelum, D. C. Winter
Morbidity and oncological outcomes of rectal cancer impaired by previous prostate malignancy. BJS 2019; 106: 1087-1098.
Authors: Z. Lakkis, D. Vernerey, D. Mege, J.‐L. Faucheron, Y. Panis, J.‐J. Tuech et al.