European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
-
Multicenter Study
Individualizing surgical treatment based on tumour response following neoadjuvant therapy in T4 primary rectal cancer.
Rectal cancer involving at least one adjacent organ (mrT4b) requires multi-visceral resection to achieve clear resection margin (R0). Performing pelvic compartment preservation according to the tumour response has not been considered. This study assesses the impact of changing the surgical strategy according to tumour response in rectal cancer mrT4b. ⋯ In Responders, TME or e-TME are technically and oncollogically feasible and should be considered in preferrence to b-TME. In Non-responders, allowing for high rates of morbidity and local recurrence in patients with e-TME, b-TME procedures should be preferred.