Interval to surgery after neoadjuvant treatment for colorectal cancer

Nir Wasserberg*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The current standard treatment of low-lying locally advanced rectal cancer consists of chemoradiation followed by radical surgery. The interval between chemoradiation and surgery varied for many years until the 1999 Lyon R90-01 trial which compared the effects of a short (2-wk) and long (6-wk) interval. Results showed a better clinical tumor response (71.7% vs 53.1%) and higher rate of positive and pathologic tumor regression (26% vs 10.3%) after the longer interval. Accordingly, a 6-wk interval between chemoradiation and surgery was set to balance the oncological results with the surgical complexity. However, several recent retrospective studies reported that prolonging the interval beyond 8 or even 12 wk may lead to significantly higher rates of tumor downstaging and pathologic complete response. This in turn, according to some reports, may improve overall and disease-free survival, without increasing the surgical difficulty or complications. This work reviews the data on the effect of different intervals, derived mostly from retrospective analyses using a wide variation of treatment protocols. Prospective randomized trials are currently ongoing.

Original languageEnglish
Pages (from-to)4256-4262
Number of pages7
JournalWorld Journal of Gastroenterology
Volume20
Issue number15
DOIs
StatePublished - 21 Apr 2014

Keywords

  • Chemoradiation therapy
  • Colorectal cancer
  • Interval to surgery
  • Neoadjuvant
  • Rectal cancer
  • Surgery

Fingerprint

Dive into the research topics of 'Interval to surgery after neoadjuvant treatment for colorectal cancer'. Together they form a unique fingerprint.

Cite this