, Volume 15, Issue 9, pp 2628-2629
Date: 18 Mar 2008

Benefits, Limitations, and Harm of Local Excision for Rectal Cancer

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To the Editor:

Major advances in surgical and medical oncology have improved treatment strategies and survival for patients with solid cancers over the last years. Currently, efforts for various cancers including colorectal, stomach, breast, and other tumors have been focused on how to achieve both local control by appropriate surgery alone or plus chemoradiotherapy14 and personalized adjuvant systemic treatment through molecular and genetic biomarkers.59

With the aim to improve quality of life (QOL), local excision and minimal access surgery, such as laparoscopic and robotic surgery,10 are increasingly used in clinical practice. However, what is the potential harm risked by less extensive surgery, particularly in the absence of randomized controlled trials? What does better QOL mean if there is an increased risk of local and nodal recurrence that may also result in increased mortality?

In a recent article, Borschitz et al. report on local excision after neoadjuvant chemoradiotherapy (n ...