The journal of Colorectal Disease has recently accepted a summary of current guidelines regarding organ preservation in rectal cancer, which has been supported by a number of ESCP members.
The potential morbidity associated with radical resection for rectal cancer is an incentive for surgeons to adopt strategies aimed at organ preservation, above all for early disease. The article provides a systematic review of national and international guidelines and consensus statements. It identifies gaps in knowledge and highlights areas for future research.
Even though rectal preserving treatment strategies for rectal cancer are mentioned in the majority of national and international guidelines, the article identifies a need to define the indications and contra-indications. Awaiting the conclusion of a number of trials, the articles concludes that rectal preservation, other than for patients with low risk T1 tumours or those for whom radical surgery is inappropriate, should still be regarded as an experimental treatment strategy until there is agreement over lymph node imaging, surveillance protocols and risk assessment based on pathological examination.
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