Current Status of the Management of Stage I Rectal Cancer

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Article number40
JournalCurrent oncology reports
Volume22
Issue number4
DOIs
StatePublished - Apr 1 2020

Keywords

  • Local excision
  • Rectal cancer
  • Stage I
  • Total mesorectal excision
  • Watch and wait

ASJC Scopus subject areas

  • Oncology

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