Affordable Access

Access to the full text

Local excision in mid-to-low rectal cancer patients who revealed clinically total or near-total regression after preoperative chemoradiotherapy; a proposed trial

Authors
  • Lee, Jong Lyul1
  • Lim, Seok-Byung1
  • Yu, Chang Sik1
  • Park, In Ja1
  • Yoon, Yong Sik1
  • Kim, Chan Wook1
  • Park, Seong Ho2
  • Lee, Jong Seok2
  • Hong, Yong Sang3
  • Kim, Sun Young3
  • Kim, Jeong Eun3
  • Kim, Jong Hoon4
  • Park, Jin-hong4
  • Kim, Jihun5
  • Han, Minkyu6
  • 1 University of Ulsan College of Medicine, Asan Medical Center, Division of Colon and Rectal Surgery, Department of Surgery, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea , Seoul (South Korea)
  • 2 University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea , Seoul (South Korea)
  • 3 University of Ulsan College of Medicine, Asan Medical Center, Department of Medical Oncology, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea , Seoul (South Korea)
  • 4 University of Ulsan College of Medicine, Asan Medical Center, Department of Radiation Oncology, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea , Seoul (South Korea)
  • 5 University of Ulsan College of Medicine, Asan Medical Center, Department of Pathology, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea , Seoul (South Korea)
  • 6 University of Ulsan College of Medicine, Asan Medical Center, Department of Clinical Epidemiology and Biostatistics, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea , Seoul (South Korea)
Type
Published Article
Journal
BMC Cancer
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Apr 29, 2019
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12885-019-5581-9
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundPreoperative chemoradiotherapy (pre-CRT) followed by total mesorectal excision (TME) is currently a standard therapy for locally advanced mid-to-low rectal cancer. Less aggressive, organ-preserving option such as local excision (LE) or watchful wait can alternatively be used for patients who respond well to pre-CRT. High-resolution rectal magnetic resonance imaging (MRI) is one of the most useful methods to assess pre-CRT response, and the MERCURY group has shown that the MR tumor regression grade (mrTRG) correlated with the pathologic TRG. The aim of this study is to compare postoperative complication and oncologic outcomes between LE and TME in mid-to-low rectal cancer patients whose tumors are mrTRG grade 1 (radiological complete remission) or 2 (predominant fibrosis; near-complete remission) after pre-CRT.MethodsA prospective, double-arm, randomized, open-labeled, single center, clinical trial will be conducted in patients with mid-to-low rectal cancer whose tumors are mrTRG 1/2 after pre-CRT at the Asan Medical Center, Seoul, Korea, after approval from the Institution Review Board. Patient medical records will be de-identified using a serial number to protect personal information. Inclusion criteria will include rectal adenocarcinoma with an inferior border < 8 cm from the anal verge, mrTRG 1/2, age > 20, and provision of informed consent. Postoperative complications will be assessed by Clavien-Dindo Classification Grade. Oncologic and functional outcomes will be collected and risk factors related to these outcomes will be investigated.DiscussionWe believed that the rate of postoperative complication of LE will be comparable to that of TME in mid-to-low advanced rectal cancer patients with a favorable response after pre-CRT.Trial registrationKCT0002579 (https://cris.nih.go.kr) Dec-2017.

Report this publication

Statistics

Seen <100 times