Surgical treatment following neoadjuvant chemoradiotherapy in locally advanced rectal cancer

Colorectal cancer is a major public health problem worldwide, and locally advanced rectal cancer (LARC) is known for its poor prognosis. A multimodal treatment approach is the only method to achieve satisfactory local recurrence and survival rates in LARC. Determining which therapeutic modality for...

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Published inThe Kaohsiung journal of medical sciences Vol. 36; no. 3; pp. 152 - 159
Main Authors Huang, Ming‐Yii, Huang, Ching‐Wen, Wang, Jaw‐Yuan
Format Journal Article
LanguageEnglish
Published BP, Asia Wiley Publishing Asia Pty Ltd 01.03.2020
John Wiley & Sons, Inc
Wiley
Subjects
Adjuvant treatment
Cancer
Cancer therapies
Chemotherapy
Colorectal cancer
Female
Health aspects
Humans
local recurrence
locally advanced rectal cancer
Male
Medical prognosis
neoadjuvant chemoradiotherapy
Neoadjuvant Therapy - methods
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - surgery
Prognosis
Quality of Life
Radiation therapy
Radiotherapy
Rectal Neoplasms - drug therapy
Rectal Neoplasms - surgery
Review
Surgery
Tumors
neoadjuvant chemoradiotherapy
local recurrence
locally advanced rectal cancer
surgery
Online AccessGet full text
ISSN1607-551X
2410-8650
2410-8650
DOI10.1002/kjm2.12161

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Abstract Colorectal cancer is a major public health problem worldwide, and locally advanced rectal cancer (LARC) is known for its poor prognosis. A multimodal treatment approach is the only method to achieve satisfactory local recurrence and survival rates in LARC. Determining which therapeutic modality for LARC has the most satisfactory influence on quality of life and disease outcome is still controversial. LARC treatment is subject to continuous advancement due to the development of new and better diagnostic tools, radiotherapy techniques, and chemotherapeutic agents. Herein, we review various therapeutic modalities for LARC from several aspects. In addition to radiotherapy techniques such as neoadjuvant chemoradiotherapy (NCRT), we discuss the progress of chemotherapy, appropriate time interval between NCRT and surgery, relationship between tumor location and NCRT efficacy/safety, wait‐and‐watch policy, and predictors of treatment response following NCRT. Because of the controversies and unanswered questions regarding NCRT treatments for LARC, additional investigations are required to determine which therapeutic approach is the most feasible for LARC patients.
AbstractList Abstract Colorectal cancer is a major public health problem worldwide, and locally advanced rectal cancer (LARC) is known for its poor prognosis. A multimodal treatment approach is the only method to achieve satisfactory local recurrence and survival rates in LARC. Determining which therapeutic modality for LARC has the most satisfactory influence on quality of life and disease outcome is still controversial. LARC treatment is subject to continuous advancement due to the development of new and better diagnostic tools, radiotherapy techniques, and chemotherapeutic agents. Herein, we review various therapeutic modalities for LARC from several aspects. In addition to radiotherapy techniques such as neoadjuvant chemoradiotherapy (NCRT), we discuss the progress of chemotherapy, appropriate time interval between NCRT and surgery, relationship between tumor location and NCRT efficacy/safety, wait‐and‐watch policy, and predictors of treatment response following NCRT. Because of the controversies and unanswered questions regarding NCRT treatments for LARC, additional investigations are required to determine which therapeutic approach is the most feasible for LARC patients.
Colorectal cancer is a major public health problem worldwide, and locally advanced rectal cancer (LARC) is known for its poor prognosis. A multimodal treatment approach is the only method to achieve satisfactory local recurrence and survival rates in LARC. Determining which therapeutic modality for LARC has the most satisfactory influence on quality of life and disease outcome is still controversial. LARC treatment is subject to continuous advancement due to the development of new and better diagnostic tools, radiotherapy techniques, and chemotherapeutic agents. Herein, we review various therapeutic modalities for LARC from several aspects. In addition to radiotherapy techniques such as neoadjuvant chemoradiotherapy (NCRT), we discuss the progress of chemotherapy, appropriate time interval between NCRT and surgery, relationship between tumor location and NCRT efficacy/safety, wait-and-watch policy, and predictors of treatment response following NCRT. Because of the controversies and unanswered questions regarding NCRT treatments for LARC, additional investigations are required to determine which therapeutic approach is the most feasible for LARC patients.Colorectal cancer is a major public health problem worldwide, and locally advanced rectal cancer (LARC) is known for its poor prognosis. A multimodal treatment approach is the only method to achieve satisfactory local recurrence and survival rates in LARC. Determining which therapeutic modality for LARC has the most satisfactory influence on quality of life and disease outcome is still controversial. LARC treatment is subject to continuous advancement due to the development of new and better diagnostic tools, radiotherapy techniques, and chemotherapeutic agents. Herein, we review various therapeutic modalities for LARC from several aspects. In addition to radiotherapy techniques such as neoadjuvant chemoradiotherapy (NCRT), we discuss the progress of chemotherapy, appropriate time interval between NCRT and surgery, relationship between tumor location and NCRT efficacy/safety, wait-and-watch policy, and predictors of treatment response following NCRT. Because of the controversies and unanswered questions regarding NCRT treatments for LARC, additional investigations are required to determine which therapeutic approach is the most feasible for LARC patients.
Colorectal cancer is a major public health problem worldwide, and locally advanced rectal cancer (LARC) is known for its poor prognosis. A multimodal treatment approach is the only method to achieve satisfactory local recurrence and survival rates in LARC. Determining which therapeutic modality for LARC has the most satisfactory influence on quality of life and disease outcome is still controversial. LARC treatment is subject to continuous advancement due to the development of new and better diagnostic tools, radiotherapy techniques, and chemotherapeutic agents. Herein, we review various therapeutic modalities for LARC from several aspects. In addition to radiotherapy techniques such as neoadjuvant chemoradiotherapy (NCRT), we discuss the progress of chemotherapy, appropriate time interval between NCRT and surgery, relationship between tumor location and NCRT efficacy/safety, wait-and-watch policy, and predictors of treatment response following NCRT. Because of the controversies and unanswered questions regarding NCRT treatments for LARC, additional investigations are required to determine which therapeutic approach is the most feasible for LARC patients.
Audience Academic
Author Huang, Ching‐Wen
Huang, Ming‐Yii
Wang, Jaw‐Yuan
AuthorAffiliation 5 Center for Cancer Research Kaohsiung Medical University Kaohsiung Taiwan
7 Department of Surgery, Faculty of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
6 Division of Colorectal Surgery, Department of Surgery Kaohsiung Medical University Hospital Kaohsiung Taiwan
3 Graduate Institute of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
8 Graduate Institute of Clinical Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
2 Department of Radiation Oncology, Faculty of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
1 Department of Radiation Oncology Kaohsiung Medical University Hospital Kaohsiung Taiwan
4 Drug Development and Value Creation Research Center Kaohsiung Medical University Kaohsiung Taiwan
9 Clinical Pharmacogenomics and Pharmacoproteomics, College of Pharmacy Taipei Medical University Taipei Taiwan
AuthorAffiliation_xml – name: 8 Graduate Institute of Clinical Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
– name: 5 Center for Cancer Research Kaohsiung Medical University Kaohsiung Taiwan
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– name: 6 Division of Colorectal Surgery, Department of Surgery Kaohsiung Medical University Hospital Kaohsiung Taiwan
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– name: 4 Drug Development and Value Creation Research Center Kaohsiung Medical University Kaohsiung Taiwan
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Copyright 2019 The Authors. published by John Wiley & Sons Australia on behalf of Kaohsiung Medical University.
2019 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia on behalf of Kaohsiung Medical University.
COPYRIGHT 2020 John Wiley & Sons, Inc.
2020. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Copyright_xml – notice: 2019 The Authors. published by John Wiley & Sons Australia on behalf of Kaohsiung Medical University.
– notice: 2019 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia on behalf of Kaohsiung Medical University.
– notice: COPYRIGHT 2020 John Wiley & Sons, Inc.
– notice: 2020. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Issue 3
Keywords neoadjuvant chemoradiotherapy
local recurrence
locally advanced rectal cancer
surgery
Language English
License Attribution-NonCommercial-NoDerivs
2019 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia on behalf of Kaohsiung Medical University.
This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
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Notes Funding information
Kaohsiung Medical University, Grant/Award Number: KMU‐TC108A04; Kaohsiung Medical University Chung‐Ho Memorial Hospital, Grant/Award Numbers: KMUH107‐7R28, KMUH107‐7R29, KMUH107‐7R30, KMUH107‐7R73, KMUH107‐7M22, KMUH107‐7M23, KMUHS10701, KMUHS10801, KMUHS10804, KMUHS10807; Taiwan Precision Medicine Initiative and Biomarker Discovery in Major Diseases of Taiwan Project, Grant/Award Number: AS‐BD‐108‐1; Ministry of Health and Welfare, Grant/Award Numbers: MOHW107‐TDU‐B‐212‐123006, MOHW107‐TDU‐B‐212‐114026B, MOHW108‐TDU‐B‐212‐114026, MOHW108‐TDU‐B‐212‐133006; Ministry of Science and Technology, Grant/Award Numbers: MOST108‐2321‐B‐037‐001, MOST108‐2314‐B‐037‐021‐MY3, MOST107‐2321‐B‐037‐003, MOST107‐2314‐B‐037‐116, MOST107‐2314‐B‐037‐022‐MY2, MOST107‐2314‐B‐037‐023‐MY2
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Funding information Kaohsiung Medical University, Grant/Award Number: KMU‐TC108A04; Kaohsiung Medical University Chung‐Ho Memorial Hospital, Grant/Award Numbers: KMUH107‐7R28, KMUH107‐7R29, KMUH107‐7R30, KMUH107‐7R73, KMUH107‐7M22, KMUH107‐7M23, KMUHS10701, KMUHS10801, KMUHS10804, KMUHS10807; Taiwan Precision Medicine Initiative and Biomarker Discovery in Major Diseases of Taiwan Project, Grant/Award Number: AS‐BD‐108‐1; Ministry of Health and Welfare, Grant/Award Numbers: MOHW107‐TDU‐B‐212‐123006, MOHW107‐TDU‐B‐212‐114026B, MOHW108‐TDU‐B‐212‐114026, MOHW108‐TDU‐B‐212‐133006; Ministry of Science and Technology, Grant/Award Numbers: MOST108‐2321‐B‐037‐001, MOST108‐2314‐B‐037‐021‐MY3, MOST107‐2321‐B‐037‐003, MOST107‐2314‐B‐037‐116, MOST107‐2314‐B‐037‐022‐MY2, MOST107‐2314‐B‐037‐023‐MY2
ORCID 0000-0002-7705-2621
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Snippet Colorectal cancer is a major public health problem worldwide, and locally advanced rectal cancer (LARC) is known for its poor prognosis. A multimodal treatment...
Abstract Colorectal cancer is a major public health problem worldwide, and locally advanced rectal cancer (LARC) is known for its poor prognosis. A multimodal...
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StartPage 152
SubjectTerms Adjuvant treatment
Cancer
Cancer therapies
Chemotherapy
Colorectal cancer
Female
Health aspects
Humans
local recurrence
locally advanced rectal cancer
Male
Medical prognosis
neoadjuvant chemoradiotherapy
Neoadjuvant Therapy - methods
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - surgery
Prognosis
Quality of Life
Radiation therapy
Radiotherapy
Rectal Neoplasms - drug therapy
Rectal Neoplasms - surgery
Review
Surgery
Tumors
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Title Surgical treatment following neoadjuvant chemoradiotherapy in locally advanced rectal cancer
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