245. Local excision after complete clinical response or minimal residual tumour following neoadjuvant therapy for rectal cancer

Abstract

Background: Multimodal treatment of rectal cancer, by combination of radiation therapy, chemotherapy and radical surgery including total mesorectal excision, has become the standard approach in patients with locally advanced rectal cancer. The use of neoadjuvant therapy results in additional benefits such as significant tumor downsizing and downstaging and a better chance of sphincter preservation in selected case. Complete rectal wall tumor regression or minimal residual lesion may be associated with the absence of viable cancer cells in the mesorectum, suggesting the possibility of a less invasive surgical treatment as an alternative to radical surgery.