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Clinical Management of Rectal Cancer
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Clinical Management of Rectal Cancer

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 2041

Special Issue Editor

Prof. Dr. Johannes Christian Lauscher

E-Mail Website
Guest Editor
Department of General and Visceral Surgery, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
Interests: colorectal cancer; colorectal surgery; surgical oncology; robotic surgery; laparoscopic surgery; postoperative outcome

Special Issue Information

Dear Colleagues,

The modern treatment of advanced rectal cancers includes the combination of the best aspects of surgical, medical and radiation oncology options. Over the last 20 years, the technical and medical development in these different treatment fields has been huge. Total neoadjuvant therapy for locally advanced rectal cancer has been shown to reduce distant failure. Robotic low anterior resection may provide potential advantages in terms of postoperative outcome and long-term functional outcome, but more evidence is needed to confirm these results. There is growing evidence that the selective use of neoadjuvant treatment in cT3 rectal cancer based on the circumferential resection margin on MRI is associated with low local recurrence rates and beneficial long-term results. Postoperative complications in rectal cancer surgery are still common and need to be managed in a timely and effective manner to obtain optimal long-term results.

Choosing the best treatment option for the individual patient by taking into consideration oncological results and functional outcomes remains challenging.

In this Special Issue, the focus will be on the results of multimodality treatments for advanced rectal cancer, taking into consideration modern surgical techniques such as robotic surgery. Of particular interest will be papers comparing the early postoperative outcome, the oncology outcome, the rate and management of complications, and the quality of life achieved using different treatments.

Prof. Dr. Johannes Christian Lauscher
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • rectal cancer
  • robotic surgery
  • laparoscopic surgery
  • total neoadjuvant therapy
  • postoperative complications
  • quality of life
  • management of postoperative complications
  • anorectal function
  • urogenital function
  • chemoradiotherapy

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Published Papers (2 papers)

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Research

Jump to: Review

14 pages, 262 KiB  
Article
Robotic-Assisted versus Laparoscopic Surgery for Rectal Cancer: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center
by Jasper Max Gebhardt, Neno Werner, Andrea Stroux, Frank Förster, Ioannis Pozios, Claudia Seifarth, Christian Schineis, Benjamin Weixler, Katharina Beyer and Johannes Christian Lauscher
J. Clin. Med. 2024, 13(6), 1795; https://doi.org/10.3390/jcm13061795 - 20 Mar 2024
Cited by 1 | Viewed by 1075
Abstract
Background: The popularity of robotic-assisted surgery for rectal cancer is increasing, but its superiority over the laparoscopic approach regarding safety, efficacy, and costs has not been well established. Methods: A retrospective single-center study was conducted comparing consecutively performed robotic-assisted and laparoscopic [...] Read more.
Background: The popularity of robotic-assisted surgery for rectal cancer is increasing, but its superiority over the laparoscopic approach regarding safety, efficacy, and costs has not been well established. Methods: A retrospective single-center study was conducted comparing consecutively performed robotic-assisted and laparoscopic surgeries for rectal cancer between 1 January 2016 and 31 September 2021. In total, 125 adult patients with sporadic rectal adenocarcinoma (distal extent ≤ 15 cm from the anal verge) underwent surgery where 66 were operated on robotically and 59 laparoscopically. Results: Severe postoperative complications occurred less frequently with robotic-assisted compared with laparoscopic surgery, as indicated by Clavien–Dindo classification grades 3b–5 (13.6% vs. 30.5%, p = 0.029). Multiple logistic regression analyses after backward selection revealed that robotic-assisted surgery was associated with a lower rate of total (Clavien–Dindo grades 1–5) (OR = 0.355; 95% CI 0.156–0.808; p = 0.014) and severe postoperative complications (Clavien–Dindo grades 3b–5) (OR = 0.243; 95% CI 0.088–0.643; p = 0.005). Total inpatient costs (median EUR 17.663 [IQR EUR 10.151] vs. median EUR 14.089 [IQR EUR 12.629]; p = 0.018) and surgery costs (median EUR 10.156 [IQR EUR 3.551] vs. median EUR 7.468 [IQR EUR 4.074]; p < 0.0001) were higher for robotic-assisted surgery, resulting in reduced total inpatient profits (median EUR −3.196 [IQR EUR 9.101] vs. median EUR 232 [IQR EUR 6.304]; p = 0.004). Conclusions: In our study, robotic-assisted surgery for rectal cancer resulted in less severe and fewer total postoperative complications. Still, it was associated with higher surgery and inpatient costs. With increasing experience, the operative time may be reduced, and the postoperative recovery may be further accelerated, leading to reduced surgery and total inpatient costs. Full article
(This article belongs to the Special Issue Clinical Management of Rectal Cancer)

Review

Jump to: Research

24 pages, 303 KiB  
Review
Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: How to Select the Most Suitable?
by Chanyoot Bandidwattanawong
J. Clin. Med. 2024, 13(17), 5061; https://doi.org/10.3390/jcm13175061 - 26 Aug 2024
Viewed by 436
Abstract
Rectal cancer shows specific characteristics in terms of pattern of recurrence, which occurs commonly at both local and distant sites. The standard of care for locally advanced rectal cancer (LARC) including neoadjuvant chemoradiotherapy, followed by surgery based on the total mesorectal excision principles [...] Read more.
Rectal cancer shows specific characteristics in terms of pattern of recurrence, which occurs commonly at both local and distant sites. The standard of care for locally advanced rectal cancer (LARC) including neoadjuvant chemoradiotherapy, followed by surgery based on the total mesorectal excision principles leads to a reduction in the rates of local recurrences to 6–7% at 5 years. However, the outcomes among those with high-risk lesions remain unsatisfactory. On the contrary, neoadjuvant chemoradiotherapy results in long-term morbidities among those with low-risk lesions. Furthermore, the overall survival benefit of neoadjuvant therapy is still a subject to be debated, except for patients with complete or near-complete response to neoadjuvant therapy. Total neoadjuvant therapy (TNT) is a new paradigm of management of high-risk rectal cancer that includes early administration of the most effective systemic therapy either before or after neoadjuvant radiotherapy with or without chemotherapy prior to surgery with or without adjuvant chemotherapy. TNT potentially improves disease-free survival, even though whether it can prolong survival has been debatable. Recently, neoadjuvant chemotherapy only has been proved to be non-inferior to neoadjuvant chemoradiotherapy in patients with low-risk lesions. This review intends to review the current evidences of neoadjuvant therapy and propose a more customized paradigm of management of LARC. Full article
(This article belongs to the Special Issue Clinical Management of Rectal Cancer)
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