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Current Colorectal Cancer Reports

, Volume 14, Issue 1, pp 31–36 | Cite as

Current Trends in the Rate of Rectal Cancer Restorative Operations in the Era of Neoadjuvant Chemoradiation

  • Holly B. Cunningham
  • Joshua J. Weis
  • Luis R. Taveras
Surgery and Surgical Innovations in Colorectal Cancer (S Huerta, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Surgery and Surgical Innovations in Colorectal Cancer

Abstract

Purpose of Review

The following review addresses the relationship between neoadjuvant chemoradiotherapy and the rate of restorative operations in patients with rectal cancer.

Recent Findings

The rate of restorative operations performed for rectal cancer has improved over the past several decades. The relationship between this increase and the addition of neoadjuvant chemoradiotherapy to the treatment regimen for locally advanced rectal cancer is still being defined. Improved rates of sphincter-sparing procedures between patients who receive preoperative chemoradiation compared to those who receive treatment postoperatively have not been supported in the literature. The patients who seem to benefit from neoadjuvant therapy in terms of sphincter preservation are those with distal tumors. Better tumor response to neoadjuvant chemotherapy and longer interval to surgical intervention appear to have little if any benefit to preserving the sphincter.

Summary

Increased rates of restorative operations for rectal cancer seem to be most significant among distal tumors. The reasons for the increase are likely multifactorial and include improvements in patient selection, surgical technique, imaging modalities, and patient care. The role of neoadjuvant chemoradiotherapy in this setting remains equivocal.

Keywords

Rectal cancer Rectal adenocarcinoma Neoadjuvant chemoradiotherapy Restorative operations Sphincter-sparing operations Sphincter preservation 

Abbreviations

NCRT

Neoadjuvant chemoradiotherapy

CRT

Chemoradiotherapy

APR

Abdominoperineal resection

LAR

Low anterior resection

TME

Total mesorectal excision

SSS

Sphincter-sparing surgery

LARC

Locally advanced rectal cancer

cCR

Clinical complete response

pCR

Pathologic complete response

CR

Complete response

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Holly B. Cunningham
    • 1
  • Joshua J. Weis
    • 1
  • Luis R. Taveras
    • 1
  1. 1.Department of SurgeryUniversity of Texas Southwestern Medical CenterDallasUSA

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