Conservative surgical treatment in rectal cancer after complete pathological response to neoadjuvant treatment. Prospective observational study
V. 170 N. 3 (2019), Research article
V. 170 N. 3 (2019)

Conservative surgical treatment in rectal cancer after complete pathological response to neoadjuvant treatment. Prospective observational study: doi: 10.7417/CT.2019.2133

Research article
Pubblicato 2019-05-10
V. Romeo
UOC Chirurgia Generale ad Indirizzo Oncologico Azienda ospedaliera San Giovanni-Addolorata Rome
S.M. Tierno
UOC Chirurgia Generale Ospedale M.G. Vannini Rome
V. Bellini
UOC Oncologia Medica Azienda ospedaliera San Giovanni-Addolorata
A.D. Andrulli
UOC Radioterapia Azienda ospedaliera San Giovanni-Addolorata
U. De Paula
UOC Radioterapia Azienda ospedaliera San Giovanni-Addolorata
F. Stipa
UOC Chirurgia Generale Ospedale M.G. Vannini Rome
D. Campagna
UOC Anatomia Patologica Azienda ospedaliera San Giovanni-Addolorata Rome, Italy
C.E. Vitelli
UOC Chirurgia Generale Ospedale M.G. Vannini Rome
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Parole chiave

Rectal cancer
Neoadjuvant therapy
Tumor regression
TAMIS
TEM
Conservative management
Sphincter preservation

Abstract

In 2012 we started a prospective observational study at San Giovanni Addolorata Hospital in Rome for patients with rectal cancer with complete response to neoadjuvant therapy (nCRT). In our, IRB approved protocol, patients are evaluated at time 0 by physical, endoscopic, pathological and radiological examinations. 6 weeks after completion of nCRT they are re-evaluated. In case of persistence or progression of disease patients undergo surgery with Total Mesorectal Excision. In case of complete or major clinical response they are reevaluated at 12 weeks and subjected to transanal surgical excision to confirm complete pathological response (pCR). If tumor is found in the transanal excision specimen the patient is operated upon whereas patients with pCR are followed up at 3 months interval.

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