Nonoperative Management for Rectal Cancer

Felipe F Quezada-Diaz; J Joshua Smith

doi:10.1016/j.hoc.2022.03.003

Nonoperative Management for Rectal Cancer

Hematol Oncol Clin North Am. 2022 Jun;36(3):539-551. doi: 10.1016/j.hoc.2022.03.003. Epub 2022 May 11.

Authors

Felipe F Quezada-Diaz¹, J Joshua Smith²

Affiliations

¹ Colorectal Unit, Department of Surgery, Complejo Asistencial Doctor Sótero del Río, Santiago, RM, Chile. Electronic address: https://twitter.com/ffquezad.
² Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue | SR-201, New York, NY 10065, USA. Electronic address: smithj5@mskcc.org.

Abstract

The treatment algorithm for locally advanced rectal cancer (LARC) has increased in complexity over the past 10 years. Nonoperative management (NOM) for rectal cancer in patients with clinical complete response (cCR) after neoadjuvant therapy has been gaining acceptance as a potential treatment option for selected LARC patients. The current challenge is to accurately select the patients with an apparent cCR, thereby correctly identifying those would-be appropriate candidates for a NOM strategy. NOM should be part of the treatment discussion of LARC, considering increasing rates of cCR, patient preference, potential quality of life gains, and the potential avoidance of surgical morbidity.

Keywords: Chemoradiation; Neoadjuvant therapy; Nonoperative management; Rectal cancer; Total neoadjuvant therapy; Watch and wait.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Chemoradiotherapy
Humans
Neoadjuvant Therapy
Neoplasm Recurrence, Local / therapy
Quality of Life*
Rectal Neoplasms* / drug therapy
Rectal Neoplasms* / therapy
Treatment Outcome

Grants and funding

P30 CA008748/CA/NCI NIH HHS/United States