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What adjuvant therapy would you offer for rectosigmoid junction adenocarcinoma after initial LAR?

Final pathology showed pT3N0, 0/27 nodes, negative margins +perforation, +PNI, pMMR.
3 Answers
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Medical Oncology · Jefferson Kimmel Cancer Center
Answered on

The ideal treatment of rectosigmoid cancers is often nebulous, as depending on their presentation, they can be approached like rectal cancer or colon cancer.

Given that this patient had initial surgery, I would approach this patient as a higher risk stage 2 colon cancer, based on the perforation as w...

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Radiation Oncology · Memorial Sloan-Kettering Cancer Center
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I agree with all of the above. The early postoperative trials did not stratify for risk factors such as T and N stage, number of negative nodes, or importantly distance from the anal verge. When the NSABP R-02 trial did not show a survival benefit chemo radiation versus chemo therapy alone, the inte...

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Medical Oncology · Providence Hood River Memorial Hospital
Answered on

I agree with Dr. @Dr. First Last that 3 months of Capecitabine (+/- oxaliplatin depending on patient specific factors) is appropriate here.

The only situation I would consider adding radiation as part of adjuvant treatment, in this case, is if it was truly a rectal cancer (completely below the perit...

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