Can pre-op chemoRT be used to potentially downstage an early stage rectal cancer (i.e. T2 N0) for a sphincter sparing operation?
Answer from: Radiation Oncologist at Academic Institution
It is certainly appropriate to consider pre-operative chemoRT in an early stage rectal cancer that would not otherwise require neoadjuvant chemoradiation.The goal here would be to convert the operation from one resulting in a permanent ostomy (APR) to one allowing sphincter sparing (LAR). Good data ...
Answer from: Radiation Oncologist at Academic Institution
I do this if requested by the referring surgeon for tumors that would otherwise require an APR. A sprinter preservation advantage is a good enough reason but there is also a small (<10%) pelvic control benefit.
Answer from: Radiation Oncologist at Academic Institution
Interesting issue...Here is how I address it:
There are basically "3 margins" from a surgical standpoint:- The superior margin is virtually never an issue.- The lateral margins: this is what the surgeons love to talk about: T.M.E.- The inferior margin: this is the crux of this question.
There...
Answer from: Radiation Oncologist at Community Practice
As @Christopher H. Crane mentioned, you've got to get the referral from a surgeon who would even mentally countenance chemoRT for a T2 rectal CA (and not to try some sort of non-APR, transanal approach to boot). But I'd say yes to the question re: sphincter sparing. Of course the most "sparing" trea...