Organ Preservation in Rectal Cancer: Functional Outcomes, Quality of Life, and Oncological Safety
DOI:
https://doi.org/10.35381/s.v.v10i2.5242Keywords:
Rectal cancer, organ preservation, bowel function, quality of life, (Source: DeCS).Abstract
Rectal cancer continues to represent a significant oncological burden worldwide. Objectives: The objective was to critically analyze functional outcomes and quality of life following treatment for rectal cancer, with an emphasis on W&W versus sphincter-preserving surgery. Methods: A review was conducted in PubMed/MEDLINE and supplemented with retrospective and prospective reference tracking of key publications and verification of metadata in PubMed. The design was chosen to integrate heterogeneous clinical evidence, including trials, cohorts, multicenter registries, and patient-reported outcome studies. Results: The evidence indicates better average bowel function with W&W, although some patients who did not undergo resection continue to experience symptoms and sequelae. LARS is specific to rectal resection and should not be automatically diagnosed when the rectum remains intact. Conclusions: The safety of W&W requires rigorous patient selection, accurate assessment, intensive monitoring, and timely rescue procedures.
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Sung H, Filho AM, Laversanne M, Ferlay J, Siegel RL, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2024: GLOBOCAN estimates of incidence and mortality worldwide for 34 cancers in 186 countries. CA Cancer J Clin. 2026;76(4): e70090. https://n9.cl/d36ak.
Keane C, Fearnhead NS, Bordeianou LG, et al; LARS International Collaborative Group. International Consensus Definition of Low Anterior Resection Syndrome. Dis Colon Rectum. 2020;63(3):274-284. doi:10.1097/DCR.0000000000001583.
Garcia-Aguilar J, Patil S, Gollub MJ, et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J Clin Oncol. 2022;40(23):2546-2556. doi:10.1200/JCO.22.00032
Verheij FS, Omer DM, Williams H, et al. Long-Term Results of Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy: The Randomized Phase II OPRA Trial. J Clin Oncol. 2024;42(5):500-506. doi:10.1200/JCO.23.01208
Custers PA, van der Sande ME, Grotenhuis BA, et al. Long-term Quality of Life and Functional Outcome of Patients With Rectal Cancer Following a Watch-and-Wait Approach. JAMA Surg. 2023;158(5): e230146. doi:10.1001/jamasurg.2023.0146.
Vatandoust S, Sposato L, Wattchow D, et al. Bowel Function in Survivors of Rectal Cancer Managed with Watch-and-Wait Versus Surgery. J Gastrointest Cancer. 2026;57(1):26. doi:10.1007/s12029-025-01389-4.
Baethge C, Goldbeck-Wood S, Mertens S. SANRA-a scale for the quality assessment of narrative review articles. Res Integr Peer Rev. 2019; 4:5. doi:10.1186/s41073-019-0064-8.
Heald RJ, Husband EM, Ryall RDH. The mesorectum in rectal cancer surgery--the clue to pelvic recurrence? Br J Surg. 1982;69(10):613-616. doi:10.1002/bjs.1800691019
Bahadoer RR, Dijkstra EA, van Etten B, et al; RAPIDO collaborative investigators. Short-course radiotherapy followed by chemotherapy before total mesorectal excision versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22(1):29-42. doi:10.1016/S1470-2045(20)30555-6
Conroy T, Bosset JF, Etienne PL, et al; Unicancer Gastrointestinal Group and Partenariat de Recherche en Oncologie Digestive Group. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22(5):702-715. doi:10.1016/S1470-2045(21)00079-6.
Conroy T, Castan F, Etienne PL, et al. Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiotherapy in patients with locally advanced rectal cancer: long-term results of the UNICANCER-PRODIGE 23 trial. Ann Oncol. 2024;35(10):873-881. doi:10.1016/j.annonc.2024.06.019
Fokas E, Schlenska-Lange A, Polat B, et al. Chemoradiotherapy Plus Induction or Consolidation Chemotherapy as Total Neoadjuvant Therapy for Patients with Locally Advanced Rectal Cancer: Long-term Results of the CAO/ARO/AIO-12 Randomized Clinical Trial. JAMA Oncol. 2022;8(1): e215445. doi:10.1001/jamaoncol.2021.5445
Maas M, Beets-Tan RGH, Lambregts DMJ, et al. Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer. J Clin Oncol. 2011;29(35):4633-4640. doi:10.1200/JCO.2011.37.7176
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