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Invited Commentary
January 2019

Chemoradiotherapy and Local Excision for Organ Preservation in Early Rectal Cancer—The End of the Beginning?

Author Affiliations
  • 1Colorectal Service,Department of Surgery, Memorial Sloan Kettering Cancer, New York, New York
JAMA Surg. 2019;154(1):54-55. doi:10.1001/jamasurg.2018.3760

Treatments that have the potential to both cure rectal cancer and preserve the rectum may offer a considerable advantage over total mesorectal excision (TME), which provides excellent tumor control but often entails a permanent colostomy or a coloanal anastomosis. In this issue of JAMA Surgery, Stijns et al1 report the results of a multicenter, nonrandomized feasibility study that investigated whether chemoradiotherapy followed by local excision (CRT-LE) is an oncologically acceptable rectum-preserving strategy for rectal cancer in stage cT1 3N0. Although the study was not powered to demonstrate the efficacy of CRT-LE compared with TME (which is the benchmark for any new treatment), it adds to the growing body of evidence supporting CRT-LE as an alternative to TME.

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