| Strategic International Session (Symposium)3(JSGS・JSGE・JGES) |
| Sat. November 7th 9:00 - 11:00 Room 9: Portopia Hotel Main Building Kairaku 3 |
| “Watch & Wait” for rectal cancer: what to do in Japan? | |||
| Tsuyoshi Konishi | |||
| University of Texas MD Anderson Cancer Center | |||
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| The possibility of organ preservation in rectal cancer with nonoperative management has gained popularity during recent years. This strategy avoids total mesorectal excision in patients who achieved clinical complete response (cCR) after neoadjuvant chemoradiotherapy. Recent studies reported comparable oncologic outcomes of the nonoperative management.compared to the conventional total mesorectal excision. With recent development of total neoadjuvant therapy and increased cCR rates, more patients with rectal cancer would likely benefit from such nonoperative management. In contrast to the Western countries where neoadjuvant chemoradiation is a standard for stage II-III rectal cancer, Japan has a “surgery-first” approach as a standard treatment for rectal cancer. Neoadjuvant chemoradiation is selectively indicated for a high risk tumors in the majority of Japanese centers, and and nonoperative management is not commonly performed. On the other hand, Japan also has advantages in promoting the nonoperative management for rectal cancer, including easy availability of high-skilled endoscopists and high penetration of minimally invasive surgery. In this presentation, we will focus on the rationale, indications and outcomes of patients with rectal cancer being treated by nonoperative management, and discuss how this strategy should be developed under the current surgical practice in Japan. |
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