The conundrum of total neoadjuvant therapy in rectal cancer

Authors

Devesh S. Ballal, Advocate Health - MidwestFollow
Tejas P. Vispute, Division of Colo-Rectal and Peritoneal Surface Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Avanish P. Saklani, Division of Colo-Rectal and Peritoneal Surface Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.

Recommended Citation

Ballal DS, Vispute TP, Saklani AP. The conundrum of total neoadjuvant therapy in rectal cancer. Colorectal Dis. Published online April 12, 2024. doi:10.1111/codi.16991

Affiliations

Advocate Lutheran General Hospital

Abstract

Total neoadjuvant therapy (TNT) has fast become the paradigm in the management of rectal cancer. The widespread adoption of this approach across the world, not only for locally advanced cancers but even for cancers that otherwise would not merit chemotherapy, leads both to an increase in treatment-related toxicity for patients and burdens the healthcare services of the country. It is important to tailor treatment to each patient based not only on the tumour but, even more importantly, on the patient's expectations and goals. The intent of treatment while prescribing TNT needs to be clear, understanding that not all patients are suitable for an organ preservation (watch and wait) approach and that the survival benefits of TNT are not as obvious as most proponents believe.

Type

Article

PubMed ID

38609336