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Comment & Response
February 23, 2022

Comment on Timing of Surgery For Patients With Rectal Cancers Not Responding to Preoperative Chemoradiation

Author Affiliations
  • 1Personalised Medicine Division, Walter and Eliza Hall Research Institute, Melbourne, Victoria, Australia
  • 2Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
JAMA Surg. 2022;157(6):548-549. doi:10.1001/jamasurg.2021.7590

To the Editor The optimal timing of surgery following chemoradiotherapy for rectal cancer continues to be debated. Adding to the literature is a recent analysis of Italian registry data,1 finding that surgery beyond 8 weeks in patients with a poor response was associated with worse survival outcomes. Based on this finding, the authors recommend patients who do not respond well to chemoradiotherapy (ypT3-4 or N1-2) should “be identified early…and undergo surgery without delay.”1 We are concerned that this strong recommendation was drawn from a single uncontrolled data series. Further, this approach is practically limited by the timing and accuracy of standard chemoradiation response assessment.

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