Organ preservation in rectal cancer: Capita Selecta

The standard operative treatment for patients with rectal cancer has a high risk for morbidity and (perioperative) mortality. Patients with an extensive tumor undergo preoperative (chemo)radiation to reduce the tumor and potential lymph node metastases. In 15-25% of patients the tumor has completely disappeared, also called a 'complete response'. Patients with a complete response may undergo organ preservation as an alternative treatment. This thesis describes several topics regarding organ preservation in rectal cancer. Methods are described to optimize the patient selection. In addition, a new follow-up schedule is proposed which is potentially more efficient and less burdensome for patients. Also, the oncological outcomes of patients after organ preservation are compared to patients after surgery. Finally, this thesis guides future research with an emphasis on exploration of new techniques to enable more accurate response prediction and assessment in rectal cancer.