Robert Klimkowski , Jakub Krzyzkowiak , Nastazja Dagny Pilonis , Krzysztof Bujko , Michal F. Kaminski
{"title":"Endoscopic resection of residual rectal neoplasia after definitive chemoradiotherapy for rectal cancer","authors":"Robert Klimkowski , Jakub Krzyzkowiak , Nastazja Dagny Pilonis , Krzysztof Bujko , Michal F. Kaminski","doi":"10.1016/j.bpg.2024.101896","DOIUrl":null,"url":null,"abstract":"<div><p>The conventional approach to treating locally advanced rectal cancer, commonly defined as cT3 or cT4 primary tumors or with nodal metastases, involves chemoradiation (CRT) followed by surgical resection. There is a growing recognition of the potential for nonsurgical management following CRT or total neoadjuvant therapy (TNT), which allows for organ preservation. “Watch and wait” strategy may be considered if complete clinical response is achieved. In cases when adenoma or superficial cancer is present, a novel approach known as “salvage endoscopic resection of the residual disease” is emerging as a viable nonsurgical option for carefully selected patients. This review discusses available evidence and future potential for endoscopic management of residual neoplasia after oncological treatment of rectal cancer.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Best Practice & Research Clinical Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1521691824000155","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
The conventional approach to treating locally advanced rectal cancer, commonly defined as cT3 or cT4 primary tumors or with nodal metastases, involves chemoradiation (CRT) followed by surgical resection. There is a growing recognition of the potential for nonsurgical management following CRT or total neoadjuvant therapy (TNT), which allows for organ preservation. “Watch and wait” strategy may be considered if complete clinical response is achieved. In cases when adenoma or superficial cancer is present, a novel approach known as “salvage endoscopic resection of the residual disease” is emerging as a viable nonsurgical option for carefully selected patients. This review discusses available evidence and future potential for endoscopic management of residual neoplasia after oncological treatment of rectal cancer.
期刊介绍:
Each topic-based issue of Best Practice & Research Clinical Gastroenterology will provide a comprehensive review of current clinical practice and thinking within the specialty of gastroenterology.