Distal Rectal Cancer: Watchful Waiting & Chemo-Radiotherapy Might be Better Than Abdominoperineal Resection

Dr. Ane L. Appelt, PhD, from the Danish Colorectal Cancer Centre South at Vejle Hospital in Denmark, and colleagues have reported that better alternatives to abdominoperineal resection for patients with distal rectal cancer might be intensive watchful waiting and chemoradiotherapy as it can avoid undesirable outcomes and it is safe. This study was recently published in The Lancet Oncology.

Dr. Ane L. Appelt and colleagues explained in their study that patients with distal T2 or T3 rectal cancers are usually treated with abdominoperineal resection as it is the standard treatment. However, abdominoperineal resection is mutilating and extensive. Therefore, the focus of their study was to assess if the combination of concomitant chemotherapy with high-dose radiotherapy and watchful waiting was a better alternative and a success for conservative (non-surgical) management of low rectal cancer.

Dr. Ane L. Appelt and colleagues conducted their study on 55 patients with T2 or T3, N0 - N1 adenocarcinoma in the lower 6 cm of the rectum. Chemoradiotherapy was given to their tumor, elective lymph node volumes, and endo-rectal brachytherapy boost with additional oral tegafur-uracil. The oral tegafur-uracil was given for 6 weeks every day except on weekends. During treatment, and 6 weeks after treatment, endoscopies were done and biopsies were taken from the tumor at baseline. Once the patient has achieved no nodal or distant metastases on computed tomography and magnetic resonance imaging, negative tumor site biopsies, and clinical tumor regression 6 weeks after treatment, they are then observed further.

Forty patients had clinical complete response out of 51 patients who were eligible. They were allocated to observation. The median follow-up period for local recurrence in the observation group was 23.9 months. Fifteen and a half percent of the observation group experienced local recurrence at 1 year. Further details on the study result can be found here. Dr. van de Velde and Dr. Breugom who were uninvolved in the study expressed their concern for the risk of possible long-term adverse effects of intensive chemoradiotherapy followed by observation versus its benefit, especially those with clinical T2 rectal cancer not given neoadjuvant chemoradiotherapy.


Image Source

Reference Source


About CancerWarrior

Courage, above all things, is the first quality of a warrior. To war with Cancer.


Top Posts | Research

Mediterranean diet

Mediterranean Dietary Lifestyle May Prevent Breast Cancer

Dr. Miguel Á. Martínez-González, MD, from the Instituto de Salud Carlos III in Madrid, and colleagues reported that breast cancer may be prevented by adopting a Mediterranean diet lifestyle that is known to be protective against cardiovascular diseases. The Mediterranean diet c ... ...

Immunological Cancer Therapy Takes Precedence

The human body is very tough. It can take a lot of abuse and still manage to function. However, just like a well-built machine, it is the internals of the human body that matter more than what is outside. So if something attacks from within, there is a chance that it may be enough to take over the ...

Sitting Linked to Increased Risk for Cancer in Women

According to a study conducted by the American Cancer Society, sitting too much can raise cancer risk in females. The study shows that women who spend 6 hours or more of their time sitting have increased cancer risk by 10% in comparison to the women who spend 3 hours of their time per day sitting.T ...

Light to Moderate Alcohol Intake Increases Cancer Risk

Dr. Edward L. Giovannucci, MD, ScD, Professor of Nutrition, Harvard T. H. Chan School of Public Health, Boston, and colleagues reported that light to moderate alcohol intake increases cancer risk. The research team urged for updated health precautions on alcohol intake. The research team explained ...

Coffee Might Lower the Recurrence Risk of Colon Cancer

Dr. Charles Fuchs, MD, MPH, from the University of Dana-Farber Cancer Institute in Boston and colleagues reported that coffee might lower the recurrence risk of colon cancer. Despite their findings, the research team warned that these findings are not evidence of causation and are only associations ...