Disruptive Analysis of Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: Clinical and Therapeutic Distinctions Between Low- and Mid-Rectal Cancers - PubMed
5 days ago
- #rectal cancer
- #neoadjuvant therapy
- #oncology
- Total neoadjuvant therapy (TNT) is a key treatment for locally advanced rectal cancer, improving systemic control and organ preservation.
- Current guidelines treat rectal cancer uniformly, ignoring differences between mid- and low-rectal tumors.
- Low-rectal cancers (<1 cm from anal ring) have complex lymphatic drainage, higher margin risks, and impact continence.
- Mid-rectal tumors are more amenable to standard resection with preserved function and may benefit from radiotherapy deintensification.
- Evidence supports tailored strategies: radiotherapy de-escalation for mid-rectal tumors and intensified TNT for low-rectal tumors.
- A location-specific, patient-centered approach can improve oncologic outcomes and quality of life.