Abstract
The current interest in organ preservation and the watch-and-wait approach has renewed the interest to assess the response after (chemo)radiation, with the goal to identify patients with a complete or very good response. The most accurate identification is achieved with a combination of digital rectal examination, endoscopy and MRI. At present there is little evidence for a role for EUS and PET, and the role of a biopsy is unclear. The detection of small islands of tumour cells in the radiotherapy-induced fibrosis remains difficult with any technique. When the goal is to increase the number of patients who can avoid a major rectal resection, patients with a very good response can be selected for a prolonged observation period with a second assessment 8-12 weeks later. This allows for a better healing of the bowel wall, and a better identification of a complete response. A key element in this approach is to involve the patient in the decision-making process.
Original language | English |
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Title of host publication | Multidisciplinary Treatment of Colorectal Cancer: Staging - Treatment - Pathology - Palliation |
Editors | Gunnar Baatrup |
Publisher | Springer International Publishing |
Pages | 249-256 |
Number of pages | 8 |
Edition | 2 |
ISBN (Electronic) | 9783030588465 |
ISBN (Print) | 9783030588458 |
DOIs | |
Publication status | Published - 16 Nov 2020 |
Keywords
- Endoscopy
- MRI
- Organ preservation
- Rectal cancer
- Restaging
- Tumour response
- Watch and wait