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Management of Rectal Neoplasia

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Multidisciplinary Treatment of Colorectal Cancer

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Abstract

The aim of the treatment of early rectal cancer is to cure the patient and minimize the risk of recurrence with the least harmful method of treatment and the best functional outcome. The method of choice will therefore depend on the individual patients’ age, frailty, the stage of the disease at presentation, the risk of complications and patient preference.

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References

  1. Rönnow CF, Arthursson V, Toth E, Krarup PM, Syk I, Thorlacius H. Lymphovascular infiltration, not depth of invasion, is the critical risk factor of metastases in early colorectal cancer: retrospective population-based cohort study on prospectively collected data, including validation. Ann Surg. 2020. https://doi.org/10.1097/SLA.0000000000003854.

  2. Jones HJS, Hompes R, Mortensen N, Cunningham C. Modern management of T1 rectal cancer by transanal endoscopic microsurgery: a 10-year single-centre experience. Color Dis. 2018;20(7):586–92.

    Article  CAS  Google Scholar 

  3. Borschitz T, Kneist W, Gockel I, Junginger T. Local excision for more advanced rectal tumors. Acta Oncol (Stockholm, Sweden). 2008;47(6):1140–7.

    Article  Google Scholar 

  4. Morino M, Risio M, Bach S, Beets-Tan R, Bujko K, Panis Y, et al. Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference. Surg Endosc. 2015;29(4):755–73.

    Article  Google Scholar 

  5. Lezoche E, Baldarelli M, Lezoche G, Paganini AM, Gesuita R, Guerrieri M. Randomized clinical trial of endoluminal locoregional resection versus laparoscopic total mesorectal excision for T2 rectal cancer after neoadjuvant therapy. Br J Surg. 2012;99(9):1211–8.

    Article  CAS  Google Scholar 

  6. You YN, Baxter NN, Stewart A, Nelson H. Is the increasing rate of local excision for stage I rectal cancer in the United States justified?: a nationwide cohort study from the National Cancer Database. Ann Surg. 2007;245(5):726–33.

    Article  Google Scholar 

  7. de Jong EA, ten Berge JC, Dwarkasing RS, Rijkers AP, van Eijck CH. The accuracy of MRI, endorectal ultrasonography, and computed tomography in predicting the response of locally advanced rectal cancer after preoperative therapy: a metaanalysis. Surgery. 2016;159(3):688–99.

    Article  Google Scholar 

  8. Krajewski KM, Kane RA. Ultrasound staging of rectal cancer. Semin Ultrasound CT MR. 2008;29(6):427–32.

    Article  Google Scholar 

  9. Heo SH, Kim JW, Shin SS, Jeong YY, Kang HK. Multimodal imaging evaluation in staging of rectal cancer. World J Gastroenterol. 2014;20(15):4244–55.

    Article  Google Scholar 

  10. Al-Sukhni E, Milot L, Fruitman M, Beyene J, Victor JC, Schmocker S, et al. Diagnostic accuracy of MRI for assessment of T category, lymph node metastases, and circumferential resection margin involvement in patients with rectal cancer: a systematic review and meta-analysis. Ann Surg Oncol. 2012;19(7):2212–23.

    Article  Google Scholar 

  11. Garcia-Aguilar J, Pollack J, Lee SH, Hernandez de Anda E, Mellgren A, Wong WD, et al. Accuracy of endorectal ultrasonography in preoperative staging of rectal tumors. Dis Colon Rectum. 2002;45(1):10–5.

    Article  Google Scholar 

  12. Balyasnikova S, Brown G. Optimal imaging strategies for rectal cancer staging and ongoing management. Curr Treat Options in Oncol. 2016;17(6):32.

    Article  Google Scholar 

  13. NICE. Improving outcomes in colorectal cancer 2004. https://www.nice.org.uk/guidance/csg5.

  14. Wang HS, Liang WY, Lin TC, Chen WS, Jiang JK, Yang SH, et al. Curative resection of T1 colorectal carcinoma: risk of lymph node metastasis and long-term prognosis. Dis Colon Rectum. 2005;48(6):1182–92.

    Article  Google Scholar 

  15. Kobayashi H, Mochizuki H, Kato T, Mori T, Kameoka S, Shirouzu K, et al. Is total mesorectal excision always necessary for T1-T2 lower rectal cancer? Ann Surg Oncol. 2010;17(4):973–80.

    Article  Google Scholar 

  16. Kikuchi R, Takano M, Takagi K, Fujimoto N, Nozaki R, Fujiyoshi T, et al. Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum. 1995;38(12):1286–95.

    Article  CAS  Google Scholar 

  17. Haggitt RC, Glotzbach RE, Soffer EE, Wruble LD. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology. 1985;89(2):328–36.

    Article  CAS  Google Scholar 

  18. Nascimbeni R, Burgart LJ, Nivatvongs S, Larson DR. Risk of lymph node metastasis in T1 carcinoma of the colon and rectum. Dis Colon Rectum. 2002;45(2):200–6.

    Article  Google Scholar 

  19. Matsuda T, Fukuzawa M, Uraoka T, Nishi M, Yamaguchi Y, Kobayashi N, et al. Risk of lymph node metastasis in patients with pedunculated type early invasive colorectal cancer: a retrospective multicenter study. Cancer Sci. 2011;102(9):1693–7.

    Article  CAS  Google Scholar 

  20. Yoshii S, Nojima M, Nosho K, Omori S, Kusumi T, Okuda H, et al. Factors associated with risk for colorectal cancer recurrence after endoscopic resection of T1 tumors. Clin Gastroenterol Hepatol. 2014;12(2):292–302.e3.

    Article  Google Scholar 

  21. Morino M, Allaix ME, Caldart M, Scozzari G, Arezzo A. Risk factors for recurrence after transanal endoscopic microsurgery for rectal malignant neoplasm. Surg Endosc. 2011;25(11):3683–90.

    Article  Google Scholar 

  22. Heo J, Jeon SW, Jung MK, Kim SK, Kim J, Kim S. Endoscopic resection as the first-line treatment for early colorectal cancer: comparison with surgery. Surg Endosc. 2014;28(12):3435–42.

    Article  Google Scholar 

  23. Nam MJ, Han KS, Kim BC, Hong CW, Sohn DK, Chang HJ, et al. Long-term outcomes of locally or radically resected T1 colorectal cancer. Color Dis. 2016;18(9):852–60.

    Article  CAS  Google Scholar 

  24. Kim JB, Lee HS, Lee HJ, Kim J, Yang DH, Yu CS, et al. Long-term outcomes of endoscopic versus surgical resection of superficial submucosal colorectal cancer. Dig Dis Sci. 2015;60(9):2785–92.

    Article  Google Scholar 

  25. Garcia-Aguilar J, Renfro LA, Chow OS, Shi Q, Carrero XW, Lynn PB, et al. Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial. Lancet Oncol. 2015;16(15):1537–46.

    Article  Google Scholar 

  26. Verseveld M, de Graaf EJ, Verhoef C, van Meerten E, Punt CJ, de Hingh IH, et al. Chemoradiation therapy for rectal cancer in the distal rectum followed by organ-sparing transanal endoscopic microsurgery (CARTS study). Br J Surg. 2015;102(7):853–60.

    Article  CAS  Google Scholar 

  27. Smart CJ, Korsgen S, Hill J, Speake D, Levy B, Steward M, et al. Multicentre study of short-course radiotherapy and transanal endoscopic microsurgery for early rectal cancer. Br J Surg. 2016;103(8):1069–75.

    Article  CAS  Google Scholar 

  28. Habr-Gama A, Sabbaga J, Gama-Rodrigues J, Sao Juliao GP, Proscurshim I, Bailao Aguilar P, et al. Watch and wait approach following extended neoadjuvant chemoradiation for distal rectal cancer: are we getting closer to anal cancer management? Dis Colon Rectum. 2013;56(10):1109–17.

    Article  Google Scholar 

  29. Dossa F, Chesney TR, Acuna SA, Baxter NN. A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2017;2(7):501–13.

    Article  Google Scholar 

  30. Rombouts AJM, Al-Najami I, Abbott NL, Appelt A, Baatrup G, Bach S, et al. Can we Save the rectum by watchful waiting or TransAnal microsurgery following (chemo) Radiotherapy versus Total mesorectal excision for early REctal Cancer (STAR-TREC study)?: protocol for a multicentre, randomised feasibility study. BMJ Open. 2017;7(12):e019474.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Odense University Hospital, Svendborg, Denmark

    Issam al-Najami

  2. Department of Surgery, Austin Health, Heidelberg, VIC, Australia

    Ravish Narotam Jootun

Authors
  1. Issam al-Najami
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  2. Ravish Narotam Jootun
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Correspondence to Issam al-Najami .

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Editors and Affiliations

  1. Department of Surgery, Odense University Hospital, Svendborg, Denmark

    Gunnar Baatrup

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al-Najami, I., Jootun, R.N. (2021). Management of Rectal Neoplasia. In: Baatrup, G. (eds) Multidisciplinary Treatment of Colorectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-58846-5_7

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  • DOI: https://doi.org/10.1007/978-3-030-58846-5_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-58845-8

  • Online ISBN: 978-3-030-58846-5

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