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Tumor Location May Affect Recurrence Risk After Rectal Cancer Treatment

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Tumor Location May Affect Recurrence Risk After Rectal Cancer Treatment

A long-term study has found that how rectal cancer is treated—and where the tumor is located—can affect the risk of cancer coming back in the same area.

Researchers looked at patients in the RAPIDO trial, who all had locally advanced rectal cancer. Some were treated with total neoadjuvant treatment (TNT), which includes short-course radiation followed by chemotherapy before surgery. Others received traditional chemoradiotherapy (CRT), which uses a longer course of radiation with chemotherapy before surgery.

After eight years, cancer returned in the pelvic area more often in the TNT group (about 11%) than in the CRT group (about 6%).

The higher risk was mainly seen in patients who had surgery that preserved the anal sphincter, rather than full removal of the rectum. In these cases, when the cancer was closer to the edge of the tissue removed, the recurrence risk was especially high—up to 25% in the TNT group.

This study shows that for patients treated with TNT, it’s especially important to pay attention to the original location of the tumor when planning surgery. If the tumor was low in the rectum, a more aggressive surgical approach may be safer to reduce the chance of cancer returning.

If you’re being treated for rectal cancer, ask your surgeon how close your tumor is to the edge of the rectum, and how that affects your treatment options.

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Dr Harsh Shah - GI & HPB Oncosurgeon in Ahmeadbad
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