Published in the Journal of the National Comprehensive Cancer Network. Here is a link to the article.
Regenstrief Institute authors: Jennifer K. Maratt, M.D., M.S.
Abstract
The determination of an optimal treatment plan for an individual patient with rectal cancer is a complex process. In addition to decisions relating to the intent of rectal cancer surgery (ie, curative or palliative), consideration must also be given to the likely functional results of treatment, including the probability of maintaining or restoring normal bowel function/anal continence and preserving genitourinary functions. Particularly for patients with distal rectal cancer, finding a balance between curative-intent therapy while having minimal impact on quality of life can be challenging. Furthermore, the risk of pelvic recurrence is higher in patients with rectal cancer compared with those with colon cancer, and locally recurrent rectal cancer is associated with a poor prognosis. Careful patient selection and the use of sequenced multimodality therapy following a multidisciplinary approach is recommended. These NCCN Guidelines Insights detail recent updates to the NCCN Guidelines for Rectal Cancer, including the addition of endoscopic submucosal dissection as an option for early-stage rectal cancer, updates to the total neoadjuvant therapy approach based on the results of recent clinical trials, and the addition of a “watch-and-wait” nonoperative management approach for clinical complete responders to neoadjuvant therapy.
Authors:
Al B Benson 1, Alan P Venook 2, Mohamed Adam 2, George Chang 3, Yi-Jen Chen 4, Kristen K Ciombor 5, Stacey A Cohen 6, Harry S Cooper 7, Dustin Deming 8, Ignacio Garrido-Laguna 9, Jean L Grem 10, Paul Haste 11, J Randolph Hecht 12, Sarah Hoffe 13, Steven Hunt 14, Hisham Hussan 15, Kimberly L Johung 16, Nora Joseph 17, Natalie Kirilcuk 18, Smitha Krishnamurthi 19, Midhun Malla 20, Jennifer K Maratt 11, Wells A Messersmith 21, Jeffrey Meyerhardt 22, Eric D Miller 23, Mary F Mulcahy 1, Steven Nurkin 24, Aparna Parikh 25, Hitendra Patel 26, Katrina Pedersen 14, Leonard Saltz 27, Charles Schneider 28, David Shibata 29, Benjamin Shogan 30, John M Skibber 3, Constantinos T Sofocleous 27, Anna Tavakkoli 31, Christopher G Willett 32, Christina Wu 33, Frankie Jones 34, Lisa Gurski 34
Affiliations:
1Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
2UCSF Helen Diller Family Comprehensive Cancer Center.
3The University of Texas MD Anderson Cancer Center.
4City of Hope National Medical Center.
5Vanderbilt-Ingram Cancer Center.
6Fred Hutchinson Cancer Center.
7Fox Chase Cancer Center.
8University of Wisconsin Carbone Cancer Center.
9Huntsman Cancer Institute at the University of Utah.
10Fred & Pamela Buffett Cancer Center.
11Indiana University Melvin and Bren Simon Comprehensive Cancer Center.
12UCLA Jonsson Comprehensive Cancer Center.
13Moffitt Cancer Center.
14Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.
15UC Davis Comprehensive Cancer Center.
16Yale Cancer Center/Smilow Cancer Hospital.
17University of Michigan Rogel Cancer Center.
18Stanford Cancer Institute.
19Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute.
20O’Neal Comprehensive Cancer Center at UAB.
21University of Colorado Cancer Center.
22Dana-Farber Cancer Institute.
23The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.
24Roswell Park Comprehensive Cancer Center.
25Mass General Cancer Center.
26UC San Diego Moores Cancer Center.
27Memorial Sloan Kettering Cancer Center.
28Abramson Cancer Center at the University of Pennsylvania.
29The University of Tennessee Health Science Center.
30The UChicago Medicine Comprehensive Cancer Center.
31UT Southwestern Simmons Comprehensive Cancer Center.
32Duke Cancer Institute.
33Mayo Clinic Comprehensive Cancer Center.
34National Comprehensive Cancer Network.
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