Locally advanced rectal cancer: Is it time for a paradigm change?
Menée à partir des données d'un essai de phase III portant sur 1 152 patients atteints d'un cancer rectal de stade cT3-3 avec ou sans envahissement ganglionnaire traité par chimioradiothérapie à base de fluorouracile puis par résection mésorectale totale (âge moyen : 63 ans ; 332 femmes), cette étude évalue l'effet du protocole chirurgical sur la survie des patients
The modern era of rectal cancer surgery started with the introduction of the concept of total mesorectal excision (TME) by Heald and Ryall.1 They reported an overall survival rate of 87% in patients who underwent a resection for a cure. The rationale behind TME has been further validated by the understanding of the importance of the circumferential resection margins and the quality of TME, both prognostic markers of recurrence and survival.2,3 To further improve these results, the use of neoadjuvant chemoradiation therapy has become the standard of care for stage 2 to 3 rectal cancer.4
JAMA Surgery , commentaire, 2017