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Conservative surgical treatment in rectal cancer after complete pathological response to neoadjuvant treatment.
V Romeo1, S M Tierno2, V Bellini3
1UOC Chirurgia Generale ad Indirizzo Oncologico Azienda ospedaliera San Giovanni-Addolorata Rome.
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 re-evaluated 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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