Chemoradiotherapy and local excision for organ preservation in early rectal cancer—the end of the beginning?
Mené sur 55 patients atteints d'un cancer du rectum de stade cT1-3N0M0 et à l'aide de questionnaires (âge moyen : 64 ans ; durée médiane de suivi : 53 mois), cet essai multicentrique de phase II évalue, du point de vue des résultats histologiques, de la qualité de vie des patients, de la récidive locale et des taux de survie à 5 ans, l'efficacité d'une chimioradiothérapie suivie d'une microchirurgie endoscopique transanale épargnant le rectum
Treatments that have the potential to both cure rectal cancer and preserve the rectum may offer a considerable advantage over total mesorectal excision (TME), which provides excellent tumor control but often entails a permanent colostomy or a coloanal anastomosis. In this issue of JAMA Surgery, Stijns et al1 report the results of a multicenter, nonrandomized feasibility study that investigated whether chemoradiotherapy followed by local excision (CRT-LE) is an oncologically acceptable rectum-preserving strategy for rectal cancer in stage cT1 3N0. Although the study was not powered to demonstrate the efficacy of CRT-LE compared with TME (which is the benchmark for any new treatment), it adds to the growing body of evidence supporting CRT-LE as an alternative to TME.
JAMA Surgery , commentaire, 2017