Adjuvant chemotherapy for ypT0N0M0 rectal cancer following chemoradiotherapy and total mesorectal excision

Radhika Kainthla, Sergio Huerta

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

The management of adenocarcinoma of the rectum is a dynamic field in oncology. The multidisciplinary approach to the management of this disease continues to evolve in each segment of its trimodality treatment. New scheduling regimens and radiosensitizing agents continue to emerge. Although total mesorectal excision continues to be the operation of choice for rectal cancers, what is done before and after surgery continues to evolve to maximize an ideal oncologic outcome with minimal morbidity. The achievement of a pathological complete response [pCR (i.e. ypT0N0)] in a fraction of patients undergoing neoadjuvant chemoradiation poses an interesting management dilemma. The cohort of patients who can achieve a pCR have superior oncologic outcomes compared to nonresponders. The present review addresses the need for adjuvant therapy in patients with a pCR. We discuss the evolution of the role of adjuvant therapy in patients with rectal cancer and the studies addressing the elimination of this strategy in all patients with rectal cancer with a goal of determining the current evidence that might result in the omission of adjuvant therapy for patients with ypT0N0 rectal cancer after chemoradiation and total mesorectal excision.

Original languageEnglish (US)
Pages (from-to)819-823
Number of pages5
JournalAnti-Cancer Drugs
Volume27
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Chemoradiotherapy
Adjuvant Chemotherapy
Rectal Neoplasms
Radiation-Sensitizing Agents
Therapeutics
Disease Management
Rectum
Adenocarcinoma
Morbidity

Keywords

  • Adjuvant chemotherapy
  • pathological complete response
  • rectal cancer
  • ypT0N0M0

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Cancer Research
  • Pharmacology (medical)

Cite this

Adjuvant chemotherapy for ypT0N0M0 rectal cancer following chemoradiotherapy and total mesorectal excision. / Kainthla, Radhika; Huerta, Sergio.

In: Anti-Cancer Drugs, Vol. 27, No. 9, 01.09.2016, p. 819-823.

Research output: Contribution to journalReview article

@article{235520c5fa504fe5bfba29ae9d3a62a1,
title = "Adjuvant chemotherapy for ypT0N0M0 rectal cancer following chemoradiotherapy and total mesorectal excision",
abstract = "The management of adenocarcinoma of the rectum is a dynamic field in oncology. The multidisciplinary approach to the management of this disease continues to evolve in each segment of its trimodality treatment. New scheduling regimens and radiosensitizing agents continue to emerge. Although total mesorectal excision continues to be the operation of choice for rectal cancers, what is done before and after surgery continues to evolve to maximize an ideal oncologic outcome with minimal morbidity. The achievement of a pathological complete response [pCR (i.e. ypT0N0)] in a fraction of patients undergoing neoadjuvant chemoradiation poses an interesting management dilemma. The cohort of patients who can achieve a pCR have superior oncologic outcomes compared to nonresponders. The present review addresses the need for adjuvant therapy in patients with a pCR. We discuss the evolution of the role of adjuvant therapy in patients with rectal cancer and the studies addressing the elimination of this strategy in all patients with rectal cancer with a goal of determining the current evidence that might result in the omission of adjuvant therapy for patients with ypT0N0 rectal cancer after chemoradiation and total mesorectal excision.",
keywords = "Adjuvant chemotherapy, pathological complete response, rectal cancer, ypT0N0M0",
author = "Radhika Kainthla and Sergio Huerta",
year = "2016",
month = "9",
day = "1",
doi = "10.1097/CAD.0000000000000400",
language = "English (US)",
volume = "27",
pages = "819--823",
journal = "Anti-Cancer Drugs",
issn = "0959-4973",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Adjuvant chemotherapy for ypT0N0M0 rectal cancer following chemoradiotherapy and total mesorectal excision

AU - Kainthla, Radhika

AU - Huerta, Sergio

PY - 2016/9/1

Y1 - 2016/9/1

N2 - The management of adenocarcinoma of the rectum is a dynamic field in oncology. The multidisciplinary approach to the management of this disease continues to evolve in each segment of its trimodality treatment. New scheduling regimens and radiosensitizing agents continue to emerge. Although total mesorectal excision continues to be the operation of choice for rectal cancers, what is done before and after surgery continues to evolve to maximize an ideal oncologic outcome with minimal morbidity. The achievement of a pathological complete response [pCR (i.e. ypT0N0)] in a fraction of patients undergoing neoadjuvant chemoradiation poses an interesting management dilemma. The cohort of patients who can achieve a pCR have superior oncologic outcomes compared to nonresponders. The present review addresses the need for adjuvant therapy in patients with a pCR. We discuss the evolution of the role of adjuvant therapy in patients with rectal cancer and the studies addressing the elimination of this strategy in all patients with rectal cancer with a goal of determining the current evidence that might result in the omission of adjuvant therapy for patients with ypT0N0 rectal cancer after chemoradiation and total mesorectal excision.

AB - The management of adenocarcinoma of the rectum is a dynamic field in oncology. The multidisciplinary approach to the management of this disease continues to evolve in each segment of its trimodality treatment. New scheduling regimens and radiosensitizing agents continue to emerge. Although total mesorectal excision continues to be the operation of choice for rectal cancers, what is done before and after surgery continues to evolve to maximize an ideal oncologic outcome with minimal morbidity. The achievement of a pathological complete response [pCR (i.e. ypT0N0)] in a fraction of patients undergoing neoadjuvant chemoradiation poses an interesting management dilemma. The cohort of patients who can achieve a pCR have superior oncologic outcomes compared to nonresponders. The present review addresses the need for adjuvant therapy in patients with a pCR. We discuss the evolution of the role of adjuvant therapy in patients with rectal cancer and the studies addressing the elimination of this strategy in all patients with rectal cancer with a goal of determining the current evidence that might result in the omission of adjuvant therapy for patients with ypT0N0 rectal cancer after chemoradiation and total mesorectal excision.

KW - Adjuvant chemotherapy

KW - pathological complete response

KW - rectal cancer

KW - ypT0N0M0

UR - http://www.scopus.com/inward/record.url?scp=84978062643&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978062643&partnerID=8YFLogxK

U2 - 10.1097/CAD.0000000000000400

DO - 10.1097/CAD.0000000000000400

M3 - Review article

C2 - 27387144

AN - SCOPUS:84978062643

VL - 27

SP - 819

EP - 823

JO - Anti-Cancer Drugs

JF - Anti-Cancer Drugs

SN - 0959-4973

IS - 9

ER -