title: Complete clinical response after neoadjuvant chemoradiation for distal rectal cancer.
abstract: Multimodality treatment of rectal cancer, with the combination of radiation therapy, chemotherapy, and surgery has become the preferred approach to locally advanced rectal cancer. The use of neoadjuvant chemoradiation therapy (CRT) has resulted in reduced toxicity rates, significant tumor downsizing and downstaging, better chance of sphincter preservation, and improved functional results. A proportion of patients treated with neoadjuvant CRT may ultimately develop complete clinical response. Management of these patients with complete clinical response remains controversial and approaches including radical resection, transanal local excision, and observation alone without immediate surgery have been proposed. The use of strict selection criteria of patients after neoadjuvant CRT has resulted in excellent long-term results with no oncological compromise after observation alone in patients with complete clinical response. Recurrences are detectable by clinical assessment and frequently amenable to salvage procedures.
authors.affiliation: Angelita & Joaquim Gama Institute, and University of Sao Paulo, Av. Dr Enéas de Carvalho Aguiar 255, Sao Paulo, SP, Brazil. gamange@uol.com.br
authors.forename: Angelita
authors.initials: A
authors.lastname: Habr-Gama
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Perez
authors.forename: Igor
authors.initials: I
authors.lastname: Proscurshim
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gama-Rodrigues
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods*; D011878:Radiotherapy; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents