Lacassagne – Université Côte d’Azur – Randomisation – REctal preservation
L.UCA.RRE Congress – November 25th, Nice
Organ preservation for rectal cancer : Not any more a lottery
TME surgery remains the standard of care for locally advanced rectal cancer. For early (T2-T3a ≤ 3cm) and intermediate (T3 b-c > 3.5 cm)tumors, there is growing interest and publications advocating organ preservation after neoadjuvant treatment achieving a clinical complete response. Habr Gama in Sao Paulo was the first surgeon recomending Watch and Wait after cCR. The OPERA trial recently was the first to give strong evidence of the benefit of radiation dose escalation using the Papillon strategy (Contact X Ray Brachytherapy boost).
There are different neoadjuvant treatment approaches and only randomized trials are able to bring good evidence of the relative merit of these strategies
The LUCARRE congress is a one day meeting where the 10 ongoing phase III trials with organ preservation as main end point will be reported. It should be possible to understand the role of these different approaches : TNT using induction or consolidation chemotherapy, local excision, radiation dose escalation using external beam radiotherapy or endocavitary techniques. A crucial point will be to discuss the best method to assess the clinical tumor reponse which is a complex and time dependent end point.
We hope this meeting will help the participants to move from evidence to change in clinical practice.
Pr Jean-Pierre Gérard