RESUMO
The existing literature suggests with a high degree of certainty that watch and wait is more cost-effective than initial total mesorectal excision. However, it is heavily reliant on poor-quality health-related quality of life data. Furthermore, the cost-effectiveness of organ preservation from a broader societal perspective has not been studied. Finally, the cost-effectiveness of emerging adjuncts to watch and wait for organ preservation, such as contact X-ray brachytherapy, local excision and total neoadjuvant therapy, need to be characterised.
Assuntos
Quimiorradioterapia , Neoplasias Retais , Humanos , Análise Custo-Benefício , Qualidade de Vida , Conduta Expectante , Terapia Neoadjuvante , Neoplasias Retais/radioterapia , Neoplasias Retais/tratamento farmacológico , Recidiva Local de Neoplasia , Resultado do TratamentoRESUMO
The currently accepted first line treatment for epidermoid anal cancer is chemoradiotherapy (CRT). Tumour size and adjacent organ involvement are the key in the pretreatment assessment for T1-T4 tumours respectively. Residual or recurrent disease following initial CRT, is best treated by salvage anorectal excision. Pathological staging systems of resections were historically validated when surgery was the primary treatment and are therefore in need of revision. We propose a new pathological staging system for salvage anorectal excision specimens to allow improved prognostic guidelines postoperatively.
