In a patient with a pT3N0 rectal adenocarcinoma, would you consider omitting nodal RT and treating only the rectal bed with adjuvant chemoradiation therapy when a large number of nodes have been removed and all found to be negative?

For example, status post resection of a 4 cm high rectal carcinoma that was believed to be in the sigmoid colon but found interoperatively to be below the peritoneal reflection with 24 negative nodes, margins negative, and no other high risk features.

Answer from: Radiation Oncologist at Academic Institution

If the decision has been made to treat the patient with adjuvant chemoradiation, I would treat the nodal regions as well as the primary operative bed, as has been done in the seminal trials on rectal cancer. The value of radiation is in preventing a pelvic recurrence that would be hard to salvage. T...

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Radiation Oncologist at Washington University School of Medicine
I agree that if you treat postoperatively you shou...

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In a patient with a pT3N0 rectal adenocarcinoma, would you consider omitting nodal RT and treating only the rectal bed with adjuvant chemoradiation therapy when a large number of nodes have been removed and all found to be negative?

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