Can pre-op chemoRT be used to potentially downstage an early stage rectal cancer (i.e. T2 N0) for a sphincter sparing operation?

It is certainly appropriate to consider pre-operative chemoRT in an early stage rectal cancer that would not otherwise require neoadjuvant chemoradiation.The goal here would be to convert the operation from one resulting in a permanent ostomy (APR) to one allowing sphincter sparing (LAR). Good data ...

I do this if requested by the referring surgeon for tumors that would otherwise require an APR. A sprinter preservation advantage is a good enough reason but there is also a small (<10%) pelvic control benefit.

Interesting issue...Here is how I address it:

There are basically "3 margins" from a surgical standpoint:
- The superior margin is virtually never an issue.
- The lateral margins: this is what the surgeons love to talk about: T.M.E.
- The inferior margin: this is the crux of this question.

There will b...

As @Dr. First Last mentioned, you've got to get the referral from a surgeon who would even mentally countenance chemoRT for a T2 rectal CA (and not to try some sort of non-APR, transanal approach to boot). But I'd say yes to the question re: sphincter sparing. Of course the most "sparing" treatment ...