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Surgery Alone May Be the Best Choice for Some Rectal Cancer Patients

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Surgery Alone May Be the Best Choice for Some Rectal Cancer Patients

Rectal cancer is a type of cancer that begins in the last part of the large intestine. Doctors often treat locally advanced rectal cancer (LARC) with surgery plus chemotherapy or radiation. But for some patients, especially those with a special genetic change called deficient mismatch repair (dMMR) or microsatellite instability-high (MSI-H), the best treatment is still uncertain.

A new study looked at 119 patients with this genetic type of rectal cancer. Researchers compared three treatments: surgery alone, surgery with chemotherapy, and surgery with both chemotherapy and radiotherapy. The goal was to see which treatment helped patients live longer and prevented the cancer from returning.

The results showed that patients who had surgery alone did just as well, and sometimes better, than those who had additional chemotherapy or radiotherapy. Surgery alone was linked to better survival, fewer local recurrences, and fewer side effects compared to surgery plus chemoradiotherapy. Adding chemotherapy did not show clear benefits in long-term survival or in stopping the cancer from spreading.

This study suggests that for patients with dMMR/MSI-H rectal cancer who cannot receive immunotherapy, surgery alone may be a safe and effective option. This could mean fewer side effects and a better quality of life after treatment.

Patients should talk with their doctors about genetic testing for their tumor and how this might guide treatment choices. Understanding whether the cancer has dMMR/MSI-H can help create a plan that avoids unnecessary treatments while keeping survival chances strong.

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Dr Harsh Shah - GI & HPB Oncosurgeon in Ahmeadbad
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