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Organ preservation in rectal cancer: current status and future perspectives

Dirk Van de Putte (UGent) , Yves Van Nieuwenhove (UGent) , Wouter Willaert (UGent) , Piet Pattyn (UGent) and Wim Ceelen (UGent)
(2015) COLORECTAL CANCER. 4(4). p.185-197
Author
Organization
Abstract
With the introduction of population screening initiatives, more patients may be amenable to local, transanal excision (LE) of early-stage rectal cancer. The most important drawback of LE is the risk of understaging node-positive disease. The most powerful predictors of node-positive disease are lymphatic invasion, submucosal invasion depth and width, tumor budding and poor differentiation. Therefore, LE should be reserved for low-risk T1 tumors in those reluctant or unable to undergo major surgery. Neoadjuvant chemoradiation followed by LE for T2 tumors allows adequate local control, and is currently being compared with anterior resection alone in randomized trials. A mere watchful waiting approach has been proposed in clinical complete responders to chemoradiation. However, given the very poor accuracy of current imaging modalities to predict a true pathological complete response, this strategy should not be offered outside of well-controlled trials.
Keywords
PREOPERATIVE CHEMORADIATION, RADIATION-THERAPY, COLORECTAL-CANCER, THICKNESS LOCAL EXCISION, COMPLETE CLINICAL-RESPONSE, radiotherapy, rectal cancer, local excision, complete response, chemoradiation, COMPLETE PATHOLOGICAL RESPONSE, ENDOLUMINAL LOCOREGIONAL RESECTION, NEOADJUVANT CHEMORADIATION THERAPY, transanal, TRANSANAL ENDOSCOPIC MICROSURGERY, TOTAL MESORECTAL EXCISION, TME, TEM

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Citation

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MLA
Van de Putte, Dirk, Yves Van Nieuwenhove, Wouter Willaert, et al. “Organ Preservation in Rectal Cancer: Current Status and Future Perspectives.” COLORECTAL CANCER 4.4 (2015): 185–197. Print.
APA
Van de Putte, D., Van Nieuwenhove, Y., Willaert, W., Pattyn, P., & Ceelen, W. (2015). Organ preservation in rectal cancer: current status and future perspectives. COLORECTAL CANCER, 4(4), 185–197.
Chicago author-date
Van de Putte, Dirk, Yves Van Nieuwenhove, Wouter Willaert, Piet Pattyn, and Wim Ceelen. 2015. “Organ Preservation in Rectal Cancer: Current Status and Future Perspectives.” Colorectal Cancer 4 (4): 185–197.
Chicago author-date (all authors)
Van de Putte, Dirk, Yves Van Nieuwenhove, Wouter Willaert, Piet Pattyn, and Wim Ceelen. 2015. “Organ Preservation in Rectal Cancer: Current Status and Future Perspectives.” Colorectal Cancer 4 (4): 185–197.
Vancouver
1.
Van de Putte D, Van Nieuwenhove Y, Willaert W, Pattyn P, Ceelen W. Organ preservation in rectal cancer: current status and future perspectives. COLORECTAL CANCER. 2015;4(4):185–97.
IEEE
[1]
D. Van de Putte, Y. Van Nieuwenhove, W. Willaert, P. Pattyn, and W. Ceelen, “Organ preservation in rectal cancer: current status and future perspectives,” COLORECTAL CANCER, vol. 4, no. 4, pp. 185–197, 2015.
@article{7036746,
  abstract     = {With the introduction of population screening initiatives, more patients may be amenable to local, transanal excision (LE) of early-stage rectal cancer. The most important drawback of LE is the risk of understaging node-positive disease. The most powerful predictors of node-positive disease are lymphatic invasion, submucosal invasion depth and width, tumor budding and poor differentiation. Therefore, LE should be reserved for low-risk T1 tumors in those reluctant or unable to undergo major surgery. Neoadjuvant chemoradiation followed by LE for T2 tumors allows adequate local control, and is currently being compared with anterior resection alone in randomized trials. A mere watchful waiting approach has been proposed in clinical complete responders to chemoradiation. However, given the very poor accuracy of current imaging modalities to predict a true pathological complete response, this strategy should not be offered outside of well-controlled trials.},
  author       = {Van de Putte, Dirk and Van Nieuwenhove, Yves and Willaert, Wouter and Pattyn, Piet and Ceelen, Wim},
  issn         = {1758-194X},
  journal      = {COLORECTAL CANCER},
  keywords     = {PREOPERATIVE CHEMORADIATION,RADIATION-THERAPY,COLORECTAL-CANCER,THICKNESS LOCAL EXCISION,COMPLETE CLINICAL-RESPONSE,radiotherapy,rectal cancer,local excision,complete response,chemoradiation,COMPLETE PATHOLOGICAL RESPONSE,ENDOLUMINAL LOCOREGIONAL RESECTION,NEOADJUVANT CHEMORADIATION THERAPY,transanal,TRANSANAL ENDOSCOPIC MICROSURGERY,TOTAL MESORECTAL EXCISION,TME,TEM},
  language     = {eng},
  number       = {4},
  pages        = {185--197},
  title        = {Organ preservation in rectal cancer: current status and future perspectives},
  url          = {http://dx.doi.org/10.2217/CRC.15.18},
  volume       = {4},
  year         = {2015},
}

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