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Updated: Jul 11, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Trends in adoption of total neoadjuvant therapy for locally advanced rectal cancer
Maria Unuvar1, Joseph Blansfield2, Shengxuan Wang3
1Geisinger Medical Center, Department of General Surgery, 100 N. Academy Ave, Danville, PA, 17822, USA.
Background:
Total neoadjuvant chemoradiation (TNT), an accepted strategy for the treatment of locally advanced rectal cancer (LARC), was first included in guidelines in 2018. We aimed to describe trends in, and factors associated with TNT receipt.
Methods:
A retrospective cohort study of adult patients with LARC was performed using the national cancer database (2012-2020). TNT status was determined, and temporal trends analyzed. Factors associated with TNT receipt were identified by stage.
Results:
A total of 51,407 patients were identified; 57.3 % received TNT. Increasing age and comorbidities were associated with higher rates of TNT receipt. Patients with stage III disease were more likely to receive TNT (stage II OR 0.92, 95%CI 0.88-0.96). Patients were 38 % more likely to get TNT after guideline inclusion (OR1.38, 95%CI 1.31-1.46).
Conclusion:
Rates of TNT were consistently above 50 % and rose after inclusion in the NCCN guidelines. This study establishes baseline patterns in rates of TNT for future benchmarking.
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