WATCH AND WAIT APPROACH IN RECTAL CANCER TREATMENT

February 2, 2016
Written by Penchev D., Maslyankov S., Kostov V., et al.
Published in General Surgery

D. Penchev¹, S. Maslyankov³, V. Kostov¹, L. Dimitrova², V. Ivanova², G.Todorov³.

1) Medical University of Sofia – Medical Faculty;

2) Medical University of Sofia – Department of Pathology;

3) II Surgical Department of UMHAT “Alexandrovska.

Disclosure: The author has declared no conflicts of interest.

Received: 28.06.15 Accepted: 19.08.15

doi: 10.5455/ijsm.20150819025133

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Abstract:

The colorectal carcinoma is the most common gastrointestinal neoplasm worldwide and in Bulgaria. Often the choice of surgical treatment is difficult, and organ-preserving surgery is not feasible. In borderline situations when choosing a surgical approach is difficult, a neoadjuvant chemoradiotherapy may downstage the disease and provide better results and more surgical options. If the treatment response is partial or complete, the possibility of carrying out sphincter-sparing surgery is increased. The aim of the study is to present a clinical case of a patient with rectal carcinoma, submitted to multimodal treatment.
Case report: The presented patient is a 65-year old female with alarming symptoms and diagnosed rectal adenocarcinoma. The patient underwent preoperative neoadjuvant treatment. After a full course of treatment, the patient was restaged and reported a complete clinical response to therapy. After recommended period, she underwent an anterior resection of the rectum. This case is an example of the potential possibilities of a multidisciplinary team in surgical oncology.
Conclusions: There are certain criteria, regarding the waiting approach in rectal carcinoma, and it subjected to a set of indications in case of a complete response to the treatment. The current case is an excellent example of performing a sphincter-spearing surgery, which may lead to higher quality of life for the target patient group. The ESMO guidelines for neoadjuvant treatment of rectal adenocarcinoma are applicable in Bulgaria.

Keywords: rectal carcinoma, neoadjuvant treatment, waiting approach, chemoradiotherapy

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Bibliography

Penchev, D., Maslyankov, S., Kostov, V., Dimitrova, L., Ivanova, V. and GTodorov, Gt. (2016) ‘Watch and wait approach in rectal cancer treatment’, International Journal of Surgery and Medicine, 2(1), pp. 39–43. doi: 10.5455/ijsm.20150819025133.