Rectal cancer is a common malignancy. The management of rectal cancer has recently evolved and has undergone a paradigm shift with the advent of treatment approaches such as total neoadjuvant therapy and the watch-and-wait approach. However, despite the recently available evidence, there is no consensus on the optimal management approach in the setting of locally advanced rectal cancer. To address some of the controversies, a joint multidisciplinary panel discussion was conducted at the Australasian Gastro-Intestinal Trials Group (AGITG) Annual Scientific Meeting in November 2022. Members from different subspecialties formed two panels and discussed three clinical cases in a debate format. Each case represented some of the complex issues faced by clinicians in this setting. The discussion is now presented in this manuscript, which depicts the different available management approaches and reiterates the importance of a multidisciplinary approach.
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http://dx.doi.org/10.1111/ajco.13974 | DOI Listing |
Ann Surg Oncol
December 2024
Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA.
Background: The Peritoneal Cancer Index (PCI), calculated intraoperatively, has previously yielded mixed results when correlated with computed tomography. This study aimed to quantify variation in this scoring method comparing radiologists' and surgeons' radiologic PCI (rPCI) assessment.
Methods: The rPCI of 104 patients treated at a single institution for peritoneal carcinomatosis was calculated by an abdominal radiologist and a surgeon.
Sci Rep
December 2024
Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China.
Recently, neoadjuvant short-course radiation therapy (SCRT) has emerged as a valid treatment option for patients with locally advanced rectal cancer (LARC). We assessed SCRT plans using volumetric-modulated arc therapy (VMAT) with Halcyon and Infinity medical linear accelerators (Linacs) and compared the plan quality and delivery efficiency across all cases. Thirty patients who underwent preoperative SCRT for LARC at the hospital were randomly selected.
View Article and Find Full Text PDFClin Colorectal Cancer
December 2024
Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address:
Background: Current American Joint Committee on Cancer (AJCC) staging for colorectal cancer utilizes TNM framework groups disease based on extent and provides prognostic information, ideally with a hierarchical logic. We sought to evaluate survival as a function of stage within the 8 edition AJCC staging system for colon and rectal cancer.
Methods: Patients with primary colon or rectal cancer diagnosed 2010-2016 were identified from the National Cancer Database (NCDB).
Am J Surg
December 2024
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address:
Background: Main purpose of this study is to investigate impact of tumor size on risk of lymph node metastasis (LNM) in pT1-stage colorectal cancer (CRC), focusing on colon, rectosigmoid junction, and rectum.
Method: Patients diagnosed with primary pT1 CRC between 2015 and 2019 were selected from National Cancer Database, utilizing International Classification of Diseases for Oncology, Third Edition (ICD-O-3) codes. We analyzed factors influencing LNM using uni- and multivariate analysis, then isolated tumor size to study its impact on LNM.
Langenbecks Arch Surg
December 2024
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Background: Lateral pelvic lymph node dissection (LPND) is a challenging surgical technique with complex anatomy and narrow pelvic manipulation. The outcomes of robotic and laparoscopic surgery for LPND are still unclear.
Methods: We retrospectively reviewed 169 consecutive patients who underwent rectal cancer surgery with LPND between 2016 and 2023.
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