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Current Status of the Management of Stage I Rectal Cancer

  • Gastrointestinal Cancers (J Meyer, Section Editor)
  • Published:
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Abstract

Purpose of Review

To summarize the current available treatments for stage I rectal cancer and the evidence that supports them.

Recent Findings

Radical surgery, or total mesorectal excision (TME) without neoadjuvant therapy, reports excellent oncologic outcomes, with 5-year disease-free survival of approximately 95%. Alternative therapies include local excision, which has acceptable long-term outcomes in some low-risk T1 tumors; but overall local excision, with or without additional chemotherapy or radiation, generally reports 5-year disease-free survival less than TME alone. New research is showing complete clinical response rates of 67% with chemoradiation combined with additional consolidation chemotherapy in T2 lesions, making watch and wait a potential strategy for stage I tumors.

Summary

Owing to its superior oncologic outcomes, radical surgery remains the mainstay of treatment for stage I tumors. Both local excision and watch and wait have advantages that may make them useful in individual patients and should be considered under the right circumstances.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, University of Texas Southwestern, 1801 Inwood Blvd WA3.316, Dallas, TX, 75390, USA

    Craig Howard Olson

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  1. Craig Howard Olson
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Correspondence to Craig Howard Olson.

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Olson, C.H. Current Status of the Management of Stage I Rectal Cancer. Curr Oncol Rep 22, 40 (2020). https://doi.org/10.1007/s11912-020-00905-y

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