In what setting do you omit adjuvant radiation therapy in a T3N0 rectal cancer?

Topics: Radiation Oncology • Gastrointestinal Cancers • Colorectal 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.

Answer from: Radiation Oncologist at Academic Institution

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...

Comments

Radiation Oncologist at CarolinaEast Radiation Oncology
Dr. @Bruce D. Minsky - to piggyback on this answer...

Radiation Oncologist at Renown Health Institute for Cancer
To piggyback on this, how about pT3N1, proximal re...

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