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Zentralbl Chir. 2006 Aug;131(4):275-84.

[Rectal carcinoma: is too much neoadjuvant therapy performed? Proposals for a more selective MRI based indication].

[Article in German]

Author information

1
Klinik für Allgemein- und Abdominalchirurgie, Klinikum der Johannes Gutenberg- Universität Mainz. sekretariat@ach.klinik.uni-mainz.de

Erratum in

  • Zentralbl Chir. 2006 Oct;131(5):428.

Abstract

The present-day optimised surgery (concept of total mesorectal excision) with quality assurance by standardized pathologic examination, advances in radiotherapy and the possibilities of high-spatial-resolution MR imaging require reconsideration of pros and contras of neoadjuvant therapy and respective data. According to the resulting new proposal neoadjuvant long-course radiochemotherapy is indicated for patients with 1) fixed questionably R0 resectable tumors, 2) mobile tumors with the MRT finding of tumor involving the mesorectal fascia or 1 mm or less from it, 3) low rectal tumors extending below the levator origin and invading beyond the muscularis propria. If a high risk of local recurrence becomes apparent during surgery (tumor perforation, incision into or through tumor) or after pathologic examination (incomplete mesorectal excision, tumor 1 mm or less from the circumferential resection margin) adjuvant radiochemotherapy is indicated. In case of lymph node metastasis postoperative chemotherapy is given.

PMID:
17004186
DOI:
10.1055/s-2006-946549
[Indexed for MEDLINE]

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