Early Rectal Cancer: Advances in Diagnosis and Management Strategies

Area of Science:

• Oncology
• Gastroenterology
• Surgical Innovation

Background:

• Colorectal cancer (CRC) is a leading cause of cancer death globally.
• Early-stage rectal cancer (RC) involves lesions confined to the bowel wall.
• Total mesorectal excision (TME) is standard but causes significant morbidity.

Purpose of the Study:

• To review diagnostic, staging, and management strategies for early RC.
• To explore organ-preserving treatments for early RC.
• To provide recommendations based on current literature.

Main Methods:

• Literature review of early rectal cancer management.
• Analysis of local resection techniques (TEM, TEO, TAMIS, EMR, UEMR, ESD).
• Evaluation of neoadjuvant and adjuvant chemoradiotherapy in early RC.

Main Results:

• Local resection may offer comparable oncological outcomes to radical surgery in selected cases.
• Adjuvant and neoadjuvant chemoradiotherapy show promising results in early RC.
• Growing interest in transanal endoscopic surgery (TES) and endoscopic resection for organ preservation.

Conclusions:

• Organ preservation through local resection and non-operative management is a viable consideration for early RC.
• Further research is needed to solidify the role of local treatments and chemoradiotherapy.
• Individualized treatment strategies are crucial for optimizing outcomes in early rectal cancer.