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<p>Multimodal therapy with radiotherapy, resection, and adjuvant chemotherapy was the standard for all patients with locally advanced rectal cancer for many years. However, patients with a&#xa0;complete response after radiotherapy may be managed with a&#xa0;watch-and-wait strategy instead of resection. The definition of complete response is based on digital rectal examination, rectoscopy, and magnetic resonance imaging. To increase the likelihood of achieving a&#xa0;complete response, immunotherapy in microsatellite-instable tumors, total neoadjuvant therapy, and dose-escalated radiotherapy have now become guideline-recommended treatment options. A&#xa0;watch-and-wait strategy includes close-knit follow-up. Patients with distal tumors, who would otherwise require a&#xa0;permanent stoma after resection or face a&#xa0;high risk of low anterior resection syndrome, benefit particularly from a&#xa0;watch-and-wait approach.</p>

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Organerhaltende Therapie des Rektumkarzinoms

  • 期刊论文

  • 发表日期：

    2026年2月10日

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  • Cihan Gani,
  • Ulrike Schempf,
  • Rüdiger Hoffmann,
  • Robert Bachmann,
  • Michael Bitzer

摘要

Multimodal therapy with radiotherapy, resection, and adjuvant chemotherapy was the standard for all patients with locally advanced rectal cancer for many years. However, patients with a complete response after radiotherapy may be managed with a watch-and-wait strategy instead of resection. The definition of complete response is based on digital rectal examination, rectoscopy, and magnetic resonance imaging. To increase the likelihood of achieving a complete response, immunotherapy in microsatellite-instable tumors, total neoadjuvant therapy, and dose-escalated radiotherapy have now become guideline-recommended treatment options. A watch-and-wait strategy includes close-knit follow-up. Patients with distal tumors, who would otherwise require a permanent stoma after resection or face a high risk of low anterior resection syndrome, benefit particularly from a watch-and-wait approach.