Rectal Cancer: Local Excision [sounds like]
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Rectal Cancer: Local Excision- Key Concepts
- Techniques
- Complications
- Oncologic Results
- Local Excision and Adjuvant Therapy
- Neoadjuvant Therapy and Local Excision
- Quality of Life
- Salvage Surgery
- Conclusion
- References
- Introduction
- Patient Selection
- T1N0
- Predicting Lymph Node Metastasis
- Depth of Invasion
- Lymphovascular Invasion and Poor Differentiation
- Tumor Budding
- T2
Local Excision- Colorectal Cancer: Postoperative Adjuvant Therapy and Surveillance
Malignancy- A 75-year-old woman underwent a transanal excision of a cT1N0M0 rectal cancer. The final pathology was T1 with negative margins and no aggressive features. What is the appropriate endoscopic surveillance regimen?
- A 56-year-old man presents to the office with biopsy-proven midrectal adenocarcinoma on colonoscopy. Rigid sigmoidoscopy in the office shows a 5-cm circumferential mass 8 cm from the anal verge. Staging evaluation with computed tomography of the chest, abdomen, and pelvis and magnetic resonance imaging of the pelvis preoperatively demonstrates a T3N1M0 cancer. What is the next step in management for this patient?
- A 72-year-old patient with severe systolic congestive heart failure and oxygen-dependent chronic obstructive pulmonary disease completes chemoradiation for a locally advanced rectal adenocarcinoma 5-cm proximal to the anal verge. Reexamination of the rectum 8 weeks after chemoradiation reveals normal, intact mucosa, and magnetic resonance imaging of the pelvis reveals no visible cancer or suspicious mesorectal nodes. What is the most appropriate therapy for this patient?
- A 62-year-old man was found to have 1-cm posterior rectal lesion that is 3 cm from the anal verge. Histopathologic findings are consistent with a well-differentiated adenocarcinoma without lymphovascular or perineural invasion. Magnetic resonance imaging shows that the tumor is limited to the submucosa and there are no suspicious mesorectal lymph nodes. Metastatic workup uncovers no findings. What is the most appropriate management?
- A 53-year-old man is diagnosed with rectal adenocarcinoma 7 cm from the anal verge. Preoperative pelvic magnetic resonance imaging (MRI) demonstrates a threatened circumferential radial margin. After total neoadjuvant chemoradiation, a repeat MRI demonstrates a persistently threatened radial margin. Which of the following adjuncts should be considered in operative planning for this patient?
Management of Rectal Cancer (2020)- Anal Cancer
- Locally Recurrent Rectal Cancer
- Rationale for Multimodality Therapy
Malignancy- A 62-year-old woman presents to the office with a 1-month history of rectal pain, bleeding, and perianal mass. On digital rectal examination and anoscopy, a 3-cm firm mass is noted at the left lateral anal canal. Inguinal examination is unremarkable. Biopsy of the mass shows moderately differentiated squamous cell carcinoma. Staging computed tomography (CT) of the chest and abdomen and magnetic resonance imaging (MRI) of the pelvis demonstrate a T2N1M0 tumor. What is the best next step in her management?
- A 61-year-old man is found to have a 2-cm mass in the mid-rectum (8 cm from the anal verge) on diagnostic colonoscopy. Biopsy reveals moderately differentiated adenocarcinoma. Computed tomography (CT) reveals no evidence of metastatic disease, and magnetic resonance imaging (MRI) demonstrates a cT3, node-negative cancer. After presentation at a multidisciplinary tumor board, the patient agrees to total neoadjuvant therapy. The patient has a complete clinical response to treatment and opts for close radiologic and endoscopic surveillance in an effort to avoid surgery. On a surveillance proctoscopy 6 months after treatment, the patient is found to have a 7-mm recurrence at the original cancer site. Which of the following is the best next step in management?
- A 45-year-old man undergoes a screening colonoscopy, which shows a 1.5-cm polyp in the rectum located 5 cm from the anal verge. Biopsy reveals well-differentiated invasive adenocarcinoma without lymphovascular invasion, perineural innovation, or tumor budding. Staging computed tomography (CT) does not show any evidence of metastatic disease, and his carcinoembryonic antigen (CEA) level is normal. Magnetic resonance imaging (MRI) of the pelvis reveals the polyp to be a T-1 lesion without any evidence of lymph node metastasis. What is the most appropriate next step in treatment?
- A 57-year-old man undergoes total neoadjuvant therapy (TNT) for management of a cT3N1M0 rectal cancer. After completion of both chemotherapy/radiotherapy and consolidation chemotherapy, the presence of complete clinical response to treatment is assessed by
- Which technical/surgical factor during proctectomy most influences the risk of local recurrence?
- Proctectomy for Rectal Cancer
- Management of Rectal Cancer 2023 Supplement (2023)
- Management of Local Recurrences
- Indications for LAR Versus Intersphincteric Resection Versus APR
- Rectal Cancer: Neoadjuvant Therapy
- Colorectal Cancer: Preoperative Evaluation and Staging
- Tailored Mesorectal Excision
- Rectal Cancer: Nonoperative Management
- Rectal Cancer Pathology Assessment
- About ASCRS Textbook of Colon and Rectal Surgery
- Abdominoperineal Resection
- Technique of Total Mesorectal Excision
- Preoperative Staging
- Colon Cancer Surgical Treatment: Principles of Colectomy
- Indications for Preoperative Neoadjuvant Therapy
- Surveillance After Rectal Cancer Treatment
- Anatomy and Embryology of the Colon, Rectum, and Anus
Deep Pelvic Total Mesorectal Excision- Indications for Extended Resection
- Considerations for Geriatric Patients Undergoing Colorectal Surgery
- Adjuvant Therapy for Rectal Adenocarcinoma
- Role of Multidisciplinary Tumor Board