Tech Coloproctol (2017) 21:573–575 DOI 10.1007/s10151-017-1651-7 CONTROVERSIES IN COLORECTAL SURGERY The good, the bad and the ugly: rectal cancers in the twenty-ﬁrst century 1 1 1 1,2,3 • • • G. P. Sa˜o Julia˜o A. Habr-Gama B. B. Vailati R. O. Perez Received: 28 March 2017 / Accepted: 2 June 2017 / Published online: 19 June 2017 Springer International Publishing AG 2017 In the management of rectal cancer with neoadjuvant beneﬁts of short-course RT demonstrated by the Swedish treatment followed by surgery, pre-operative chemoradia- trials were challenged due to the absence of standardized tion used to be directed by the risk of development of local surgery with total mesorectal excision (TME). At that time, recurrence. In this setting, risk-stratiﬁcation restricted the it was unclear whether RT would still result in superior indications for neoadjuvant treatment for patients with local disease control in the setting of optimal surgical high-risk (‘‘ugly’’) or intermediate risk (‘‘bad’’) tumors resection. Then, the completion of Dutch (short-course RT) based on distance from circumferential resection margin and German (long-course CRT) trials in the setting of (CRM), depth of mesorectal invasion, presence of lymph proper TME surgery deﬁnitively demonstrated the beneﬁts node metastases or extramural venous invasion.
Techniques in Coloproctology – Springer Journals
Published: Jun 19, 2017
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