RECTAL CANCER

Organ preservation versus radical surgery for early-stage rectal cancer

Some patients with early-stage rectal cancer might be unsuitable for primary total mesorectal excision owing to the short-term surgical risks. A randomized, open-label feasibility study assessed the safety and efficacy of a short-course of radiotherapy followed by transanal endoscopic microsurgery, compared with total mesorectal excision, in patients with early-stage rectal cancer. At 15 UK sites, 55 patients with early-stage rectal adenocarcinoma (aged ≥18 years) were randomly assigned: 27 to the organ-preserving strategy and 28 to radical surgery. Of 27 patients assigned to organ preservation, 8 (30%) were converted to radical surgery. Serious adverse effects were reported in 4 of 27 (15%) patients randomly assigned to organ preservation versus 11 of 28 (39%) randomly assigned to total mesorectal excision (P = 0.04). Of 27 patients assigned to organ preservation, 8 (30%) achieved a complete response to radiotherapy. Patients in the organ-preservation group showed improvements in quality of life compared with patients undergoing radical surgery.

References

Original article

  1. Bach, S. P. et al. Radical surgery versus organ preservation via short-course radiotherapy followed by transanal endoscopic microsurgery for early-stage rectal cancer (TREC): a randomised, open-label feasibility study. Lancet Gastroenterol. Hepatol. https://doi.org/10.1016/S2468-1253(20)30333-2 (2020)

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Jordan Hindson.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Hindson, J. Organ preservation versus radical surgery for early-stage rectal cancer. Nat Rev Gastroenterol Hepatol 18, 82 (2021). https://doi.org/10.1038/s41575-021-00414-8

Download citation

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing