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Neoadjuvant treatment of colorectal cancer: comprehensive review.
Smith, Henry G; Nilsson, Per J; Shogan, Benjamin D; Harji, Deena; Gambacorta, Maria Antonietta; Romano, Angela; Brandl, Andreas; Qvortrup, Camilla.
Afiliación
  • Smith HG; Abdominalcenter K, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
  • Nilsson PJ; Department of Molecular Medicine and Surgery, Karolinska Institutet and Dept. of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.
  • Shogan BD; Department of Surgery, The University of Chicago Medicine, Chicago, Illinois, USA.
  • Harji D; Department of Colorectal Surgery, Manchester University NHS Foundation Trust, Manchester, UK.
  • Gambacorta MA; Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy.
  • Romano A; Dipartimento di Scienze Radiologiche ed Ematologiche, Universita Cattolica del Sacro Cuore, Rome, Italy.
  • Brandl A; Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy.
  • Qvortrup C; Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
BJS Open ; 8(3)2024 May 08.
Article en En | MEDLINE | ID: mdl-38747103
ABSTRACT

BACKGROUND:

Neoadjuvant therapy has an established role in the treatment of patients with colorectal cancer. However, its role continues to evolve due to both advances in the available treatment modalities, and refinements in the indications for neoadjuvant treatment and subsequent surgery.

METHODS:

A narrative review of the most recent relevant literature was conducted.

RESULTS:

Short-course radiotherapy and long-course chemoradiotherapy have an established role in improving local but not systemic disease control in patients with rectal cancer. Total neoadjuvant therapy offers advantages over short-course radiotherapy and long-course chemoradiotherapy, not only in terms of increased local response but also in reducing the risk of systemic relapses. Non-operative management is increasingly preferred to surgery in patients with rectal cancer and clinical complete responses but is still associated with some negative impacts on functional outcomes. Neoadjuvant chemotherapy may be of some benefit in patients with locally advanced colon cancer with proficient mismatch repair, although patient selection is a major challenge. Neoadjuvant immunotherapy in patients with deficient mismatch repair cancers in the colon or rectum is altering the treatment paradigm for these patients.

CONCLUSION:

Neoadjuvant treatments for patients with colon or rectal cancers continue to evolve, increasing the complexity of decision-making for patients and clinicians alike. This review describes the current guidance and most recent developments.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Terapia Neoadyuvante Límite: Humans Idioma: En Revista: BJS Open Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Terapia Neoadyuvante Límite: Humans Idioma: En Revista: BJS Open Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca