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Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 12/2016

Open Access 01-12-2016 | Clinical Guides in Oncology

SEOM Clinical Guideline of localized rectal cancer (2016)

Authors: E. González-Flores, F. Losa, C. Pericay, E. Polo, S. Roselló, M. J. Safont, R. Vera, J. Aparicio, M. T. Cano, C. Fernández-Martos

Published in: Clinical and Translational Oncology | Issue 12/2016

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Abstract

Localized rectal adenocarcinoma is a heterogeneous disease and current treatment recommendations are based on a preoperative multidisciplinary evaluation. High-resolution magnetic resonance imaging and endoscopic ultrasound are complementary to do a locoregional accurate staging. Surgery remains the mainstay of treatment and preoperative therapies with chemoradiation (CRT) or short-course radiation (SCRT) must be considered in more locally advanced cases. Novel strategies with induction chemotherapy alone or preceding or after CRT (SCRT) and surgery are in development.
Literature
1.
Dykewicz CA. Summary of the guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Clin Infect Dis. 2001;33:139–44.CrossRefPubMed
2.
3.
Bipat S, Glas AS, Slors FJ, Zwinderman AH, Bossuyt PM, Stoker J. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging meta-analysis. Radiology. 2004;232(3):773e83.CrossRef
4.
Taylor FG, Quirke P, Heald RJ, Moran BJ, Blomqvist L, Swift IR, et al. Preoperative magnetic resonance imaging assessment of circumferential resection margin predicts disease-free survival and local recurrence: 5-year follow-up results of the MERCURY study. J Clin Oncol. 2014;32(1):34–43.CrossRefPubMed
5.
Smith NJ, Barbachano Y, Norman AR, Swift RI, Abulafi AM, Brown G. Prognostic significance of magnetic resonance imaging detected extramural vascular invasion in rectal cancer. Br J Surg. 2008;95(2):229–36.CrossRefPubMed
6.
Patel UB, Taylor F, Blomqvist L, George C, Evans H, Tekkis P, et al. Magnetic resonance imaging-detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY experience. J Clin Oncol. 2011;29(28):3753–60.CrossRefPubMed
7.
Maas M, Lambregts DM, Nelemans PJ, Heijnen LA, Martens MH, Leijtens JW, et al. Assessment of clinical complete response after chemoradiation for rectal cancer with digital rectal examination, endoscopy, and MRI: selection for organ-saving treatment. Ann Surg Oncol. 2015;22:3873–80.CrossRefPubMedPubMedCentral
8.
Clancy C, Burke JP, Albert MR, O’Connell PR, Winter DC. Transanal endoscopic microsurgery versus standard transanal excision for the removal of rectal neoplasms: a systematic review and meta-analysis. Dis Colon Rectum. 2015;58(2):254–61. doi:10.​1097/​DCR.​0000000000000309​.CrossRefPubMed
9.
10.
Sajid MS, Farag S, Leung P, Sains P, Miles WF, Baig MK. Systematic review and meta-analysis of published trials comparing the effectiveness of transanal endoscopic microsurgery and radical resection in the management of early rectal cancer. Colorectal Dis. 2014;16(1):2–14. doi:10.​1111/​codi.​12474.CrossRefPubMed
11.
12.
Junginger T, Goenner U, Hitzler M, Trinh TT, Heintz A, Wollschlaeger D, et al. Long-term oncologic outcome after transanal endoscopic microsurgery for rectal carcinoma. Dis Colon Rectum. 2016;59(1):8–15 PMID: 26651106.CrossRefPubMed
13.
Garcia-Aguilar J, Renfro LA, Chow OS, Shi Q, Carrero XW, Lynn PB, et al. Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial. Lancet Oncol. 2015;16(15):1537–46. doi:10.​1016/​S1470-2045(15)00215-6.CrossRefPubMedPubMedCentral
14.
Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, de Lange-de Klerk ES, COLOR II Study Group, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;372(14):1324–32. doi:10.​1056/​NEJMoa1414882 PMID: 25830422.CrossRefPubMed
15.
Sauer R, Becker H, Hohengerger W, Rödel C, Wittekind C, Fietkau R, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Eng J Med. 2004;351:1731–40.CrossRef
16.
Gerard JO, Conroy T, Bonnetain F, Bouché O, Chapet O, Closon-Dejardin MT, et al. Preoperative radiotherapy with or without concurrent fluoruracil and leucovorin in T3-4 rectal cancers: results of FFOD9203. J Clin Oncol. 2006;24:4620–5.CrossRefPubMed
17.
Bosset JF, Collette L, Calais G, Mineur L, Maingon P, Radosevic-Jelic L, et al. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med. 2006;355:1114–23.CrossRefPubMed
18.
Hofheinz RD, Wenz F, Post S, Matzdorff A, Laechelt S, Hartmann JT, et al. Chemoradiotherapy with capecitabine versus fluoruracil for locally advanced rectal cancer: a randomized, multicentre, non-inferiority, phase 2 trial. Lancet Oncol. 2012;13:579–88.CrossRefPubMed
19.
O`Connell MJ, Colangelo LH, Beart RW, Petrelli NJ, Allegra CJ, Sharif S, et al. Capecitabine and oxaliplatin in the preoperative multimodality tratment of rectal cancer:surgical end points from the National Surgical Adjuvant Breast and Bowel Proyect trial R-04. J Clin Oncol. 2014;32:1927–34.CrossRef
20.
Aschele C, Cioni L, Lonardi S, Pinto C, Cordio S, Rosati G, et al. Primary tumor response to preoperatively chemoradiation with or without oxaliplatin in locally advanced rectal cáncer: pathological results of the STAR01 randomized phase III trail. J CIin Oncol. 2011;29:2773–80.CrossRef
21.
Rodel C, Graeven U, Fietkau R, Hohenberger W, Hothorn T, Arnold D, et al. Oxaliplatin added to fluoruracil-based preoperatively chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO 04-study): final results of the multicentre, open-label, randomized, phase 3 trial. Lancet Oncol. 2015;16:979–89.CrossRefPubMed
22.
Van Gijn W, Marignen CA, Nagtegaal ID, Kranenbarg EM, Putter H, Wiggers T, et al. Preoperative radiotherapy combined with total mesorrectal excision for resectable rectal cáncer: 12 years follow-up of the multicentre, randomized controlled TME trial. Lancet Oncol. 2011;12:575–82.CrossRefPubMed
23.
Bujko K, Nowacki MP, Nasierowska-Guttmejer A, Michalski W, Bebenek M, Kryj M, et al. Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg. 2006;93:1215–23.CrossRefPubMed
24.
Ngan SY, Burmeister B, Fisher RJ, Solomon M, Goldstein D, Joseph D, et al. Randomized trial of short-course radiotherapy versus long course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer. J Clin Oncol. 2012;30:3827–33.CrossRefPubMed
25.
Sclafani F, Brown G, Cunningham D, Wotherspoon A, Tait D, Peckitt C, et al. PAN-EX: a pooled analysis of two trials of neoadjuvant chemotherapy followed by chemoradiotherapy in MRI-defined, locally advanced rectal cancer. Ann Oncol. 2016;27(8):1557–65.CrossRefPubMed
26.
Fernandez-Martos C, Garcia-Albeniz X, Pericay C, Maurel J, Aparicio J, Montagut C, et al. Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trial. Ann Oncol. 2015;26:1722–8.CrossRefPubMed
27.
Maréchal R, Vos B, Polus M, Delaunoit T, Peeters M, Demetter P, et al. Short course chemotherapy followed by concomitant chemoradiotherapy and surgery in locally advanced rectal cancer: a randomized multicentric phase II study. Ann Oncol. 2012;23:1525–30.CrossRefPubMed
28.
Perez K, Safran H, Sikov W, Vrees M, Klipfel A, Shah N, et al. Complete neoadjuvant treatment for rectal cancer: the Brown University Oncology Group CONTRE Study. Am J Clin Oncol. 2014. [Epub ahead of print].
29.
Schou JV, Larsen FO, Rasch L, Linnemann D, Langhoff J, Høgdall E, et al. Induction chemotherapy with capecitabine and oxaliplatin followed by chemoradiotherapy before total mesorectal excision in patients with locally advanced rectal cancer. Ann Oncol. 2012;23:2627–33.CrossRefPubMed
30.
Bosset JF, CalaisG Mineur L, Maingon P, Stojanovic-Rundic S, Bensadoun RJ, et al. Fluorouracil-based adjuvant chemotherapy after preoperative chemoradiotherapy in rectal cancer: ong-term results of the EORTC 22921 randomised study. Lancet Oncol. 2014;15:184–90.CrossRefPubMed
31.
Sainato A, CernuscoLunaNunzia V, Valentini V, De Paoli A, Maurizi ER, Lupattelli M, et al. No benefit of adjuvant Fluorouracil Leucovorin chemotherapy after neoadjuvant chemoradiotherapy in locally advanced cancer of the rectum (LARC): Long term results of a randomized trial (I-CNR-RT). Radiother Oncol. 2014;113(2):223–9.CrossRefPubMed
32.
Breugom AJ, van Gijn W, Muller EW, Berglund Å, van den Broek CB, Fokstuen T, et al. Adjuvant chemotherapy for rectal cancer patients treated with preoperative (Chemo)radiotherapy and total mesorectal excision: a Dutch Colorectal Cancer Group (DCCG) randomized phase III trial. Ann Oncol. 2015;26:696–701.CrossRefPubMed
33.
Glynne-Jones R, Counsell N, Quirke P, Mortensen N, Maraveyas A, Meadows HM, et al. Chronicle: results of a randomized phase III trial in locally advanced rectal cancer after neoadjuvant chemoradiation randomizing postoperative adjuvant capecitabine plus oxaliplatin (XELOX) versus control. Ann Oncol. 2014;25:1356–62.CrossRefPubMed
34.
Hong YS, Nam BH, Kim KP, Kim JE, Park SJ, Park YS, et al. Oxaliplatin, fluorouracil, and leucovorin versus fluorouracil and leucovorin as adjuvant chemotherapy for locally advanced rectal cancer after preoperative chemoradiotherapy (ADORE): an open-label, multicentre, phase 2, randomised controlled trial. Lancet Oncol. 2014;15:1245–53.CrossRefPubMed
35.
Maas M, Nelemans PJ, Valentini V, Das P, Rödel C, Kuo LJ, et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data. Lancet Oncol. 2010;11:835–44.CrossRefPubMed
36.
Maas M, Nelemans PJ, Valentini V, Crane CH, Capirci C, Rödel C, et al. Adjuvant chemotherapy in rectal cancer: defining subgroups who may benefit after neoadjuvant chemoradiation and resection: a pooled analysis of 3313 patients. Int J Cancer. 2015;137:212–20.CrossRefPubMed
37.
Caravatta L, Picardi V, Tambaro R, Padula GD, Macchia G, Deodato F, et al. Neoadjuvant accelerated concomitant boost radiotherapy and multidrug chemotherapy in locally advanced rectal cancer: a dose-escalation study. Am J Clin Oncol. 2012;35(5):424–31.CrossRefPubMed
38.
Braendengen M, Tveit KM, Berglund A, Birkemeyer E, Frykholm G, Pahlman L, et al. Randomized phase III study comparing preoperative radiotherapy with chemora- diotherapy in nonresectable rectal cancer. J Clin Oncol. 2008;26:3687–94.CrossRefPubMed
39.
Gérard JP, Azria D, Gourgou-Bourgade S, Martel-Laffay I, Hennequin C, Etienne PL, et al. Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial ACCORD 12/0405-Prodige 2. J Clin Oncol. 2010;28(10):1638–44.CrossRefPubMed
40.
Steele SR, Chang GJ, Hendren S, Weiser M, Irani J, Buie WD, et al. Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. Practice guideline for the surveillance of patients after curative treatment of colon and rectal cancer. Dis Colon Rectum. 2015;58:713–25.CrossRefPubMed
41.
Pita-Fernández S, Alhayek-Aí M, González-Martín C, López-Calviño B, Seoane-Pillado T, Pértega-Díaz S. Intensive follow-up strategies improve outcomes in non metastatic colorectal cancer patients after curative surgery: a systematic review and meta-analysis. Ann Oncol. 2015;26:644–62.CrossRefPubMed
42.
Young PE, Womeldorph CM, Johnson EK, Maykel JA, Brucher B, Stojadinovic A, et al. Early detection of colorectal cancer recurrence in patients undergoing surgery with curative intent: current status and challenges. J Cancer. 2014;5:262–71.CrossRefPubMedPubMedCentral
43.
Enríquez-Navascués JM, Aintzane Lizerazu NB, Placer C, Elosegui JL, Ciria JP, Lacasta A, et al. Patterns of local recurrence in rectal cancer after a multidisciplinary approach. World J Gastroenterol. 2011;17:1674–84.CrossRefPubMedPubMedCentral
44.
Tanis PJ, Doeksen A, van Lanschot JJ. Intentionally curative treatment of locally recurrent rectal cancer: a systematic review. Can J Surg. 2013;56:135–44.CrossRefPubMedPubMedCentral
45.
Lee JH, Kim DY, Kim SY, Park JW, Choi HS, Oh JH, et al. Clinical outcomes of chemoradiotherapy for locally recurrent rectal cancer. Radiat Oncol. 2011;6:51.CrossRefPubMedPubMedCentral
46.
You YT, Chen JS, Wang JY, Tang R, Changchien CR, Chiang JM, et al. Concurrent chemoradiotherapy in the treatment of locally recurrent rectal cancer. Hepatogastroenterology. 2013;60:94–8.PubMed
47.
Valentini V, Morganti AG, Gambacorta MA, Mohiuddin M, Doglietto GB, Coco C, et al. Preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiated to the pelvis: a multicentric phase II study. Int J Radiat Oncol Biol Phys. 2006;64:1129–39.CrossRefPubMed
48.
Fernandez-Martos C, Brown G, Estevan R, Salud A, Montagut C, Maurel J, et al. Preoperative chemotherapy in patients with intermediate-risk rectal adenocarcinoma selected by high- resolution magnetic resonance imaging: the GEMCAD 0801 Phase II Multicenter Trial. Oncologist. 2014;19:1042–3.CrossRefPubMedPubMedCentral
49.
Schrag D, Weiser MR, Goodman KA, Gonen M, Hollywood E, Cercek A, et al. Neoadjuvant chemotherapy without routine use of radiation therapy for patients with locally advanced rectal cancer: a pilot trial. J Clin Oncol. 2014;32(6):513–8.CrossRefPubMed
50.
Petrelli F, Sgroi G, Sarti E, Barni S. Increasing the interval between neoadjuvant chemoradiotherapy and surgery in rectal cancer: a meta-analysis of published studies. Ann Surg. 2016;263:458–64.CrossRefPubMed
51.
Garcia-Aguilar J, Chow OS, Smith DD, Marcet JE, Cataldo PA, Varma MG, et al. Effect of adding mFOLFOX6 after neoadjuvant chemoradiation in locally advanced rectal cancer: a multicentre, phase 2 trial. Lancet Oncol. 2015;16:957–66.CrossRefPubMedPubMedCentral
52.
Smith JJ, Chow OS, Gollub MJ, Nash GM, Temple LK, Weiser MR, et al. Organ Preservation in Rectal Adenocarcinoma: a phase II randomized controlled trial evaluating 3-year disease-free survival in patients with locally advanced rectal cancer treated with chemoradiation plus induction or consolidation chemotherapy, and total mesorectal excision or nonoperative management. BMC Cancer. 2015;23(15):767.CrossRef
53.
Bujko K, Wyrwicz L, Rutkowski A, Malinowska M, Pietrzak L, Kryński J, et al. Long-course oxaliplatin-based preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for cT4 or fixed cT3 rectal cancer: results of a randomized phase III study. Ann Oncol. 2016;27:834–42.CrossRefPubMed
54.
Metadata
Title
SEOM Clinical Guideline of localized rectal cancer (2016)
Authors
E. González-Flores
F. Losa
C. Pericay
E. Polo
S. Roselló
M. J. Safont
R. Vera
J. Aparicio
M. T. Cano
C. Fernández-Martos
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 12/2016
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-016-1591-0

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