[Organ preserving strategies for rectal cancer treatment].
For rectal cancers, the current standard of care consists of chemoradiation followed by radical surgery with total mesorectal excision. Oncologic results are good, especially regarding local recurrence rates, but at the cost of high morbidity rates and poor anorectal, urinary and sexual function results. Since chemoradiation yields 15 to 25% pathological complete response, the role of radical surgery is questioned for patients presenting with good response after chemoradiation and two organ preservation strategies have been offered: watch and wait strategy and local excision strategy. The aim of this review is to give the results of organ preservation after chemoradiotherapy series and to highlight different questions regarding initial patient's selection, complete clinical response definition, risk of mesorectal nodal involvement, follow-up modalities as well as oncologic and functional results.
Service de radiothérapie, hôpital Haut-Lévêque, avenue de Magellan, 33604 Pessac cedex, France. Electronic address: veronique.vendrely@chu-bordeaux.fr.
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V
Vendrely
Service de chirurgie viscérale, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France.
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Q
Denost
Service de radiothérapie, hôpital Haut-Lévêque, avenue de Magellan, 33604 Pessac cedex, France.
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F
Amestoy
Service de chirurgie viscérale, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France.
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Célérier
Service d'oncologie médicale, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France.
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D
Smith
Service d'anatomopathologie, hôpital Pellegrin, place Amélie-Rabat-Léon, 33000 Bordeaux, France.
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A
Rullier
Service de chirurgie viscérale, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France.
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Rullier
D059248:Chemoradiotherapy; D003663:Decision Trees; D006801:Humans; D059351:Organ Sparing Treatments; D012004:Rectal Neoplasms / Q000601:surgery / Q000628:therapy*; D057832:Watchful Waiting
Cancer du rectum; Chimioradiothérapie; Exérèse locale; Local excision; Organ preservation; Préservation d’organe; Rectal cancer; Tumour response; Watch and wait