Nové trendy v neoadjuvantní léčbě lokálně pokročilého karcinomu rekta z pohledu chirurga - komentář

Title in English New trends in neoadjuvant therapy of locally advanced rectal cancer from a surgeon’s perspective - a commentary
Authors

KALA Zdeněk ZATLOUKAL Martin ČAN Vladimír HEMMELOVÁ Beáta OSTŘÍŽKOVÁ Lenka BOHATÁ Šárka SLABÝ Ondřej SVOBODA Marek ŠLAMPA Pavel

Year of publication 2020
Type Article in Periodical
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.linkos.cz/casopis-klinicka-onkologie/2020-10-19-5/nove-trendy-v-neoadjuvantni-lecbe-lokalne-pokrocileho-karcinomu-rekta-z-pohledu/
Doi http://dx.doi.org/10.14735/amko2020362
Keywords rectal cancer; surgical oncology; neoadjuvant therapy; organ sparing treatment; time management
Description Rectal cancer treatment advanced rapidly during last decades. The most important factors of this progress are new neoadjuvant therapy options, improvement in imaging (allowing for quality staging and restaging) and routine implementation of the total mesorectal excision technique. For the best outcomes, it is crucial to combine the treatment methods in the best way possible with ideal timing. It is necessary to keep in mind both advantages and complications of the individual kinds of approach. Therefore, interdisciplinary agreement is essential in the treatment of rectal cancer. Considering these new therapeutic possibilities, the debate about timing, indication and radicality of the surgical procedures is reopened. Surgical approaches are currently focused on mini-invasive methods and robotic surgery. New trend with promising potential seems to be clinical complete response achievement with watch and wait follow-up strategy. This approach, in the spirit of the organ sparing philosophy, however asks new questions about indication, timing and conception of this method. Proper answers are essential for sparing, yet radical oncotherapy of this disease.
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