Multicenter prospective study of risk-adapted omission of neoadjuvant chemoradiotherapy in rectal cancer
Prof. Theodor Junginger
Most guideline recommend neoadjuvant chemoradiotherapy (nCRT) for all patients with clinical stage II and III rectal cancer. The prospective OCUM study in Germany and Switzerland evaluated omission of nCRT in patients with tumor-free mesorectal fascia (mrMRF) on pelvic MRI. In approximately half of patients with advanced rectal cancer, nCRT was omitted because of tumor-free mrMRF, The 5-year overall rate of locoregional recurrence (LR) was less than 5%. Patients with involved mrMRF and/or cT4 tumors who received nCRT followed by surgery had a slightly higher LR rate but the highest rate of distant metastasis and the worst prognosis.
