In what setting do you omit adjuvant radiation therapy in a T3N0 rectal cancer?
The NCCN guidelines categorically recommend adjuvant XRT for a cT1-2N0 rectal adenocarcinoma upstaged to a pT3N0, yet there are multiple institutional series with low recurrence rates with surgery alone in T3N0 patients in whom adjuvant chemoradiation is omitted. This questions presumes high-volume colorectal surgeons performing good TMEs with negative margins.
1 Answer
Mednet Member
Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on
The 1990 NCI consensus guidelines recommend postop chemoradiation for patients with pT3N0M0 rectal cancer. However, that was before TME was routine. In patients with pT3N0M0 disease who undergo a TME and have at least 12 nodes examined, I do not recommend radiation. The benefit of radiation is a 3-4...
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