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Total Neoadjuvant Therapy for rectal cancer: Totally Not Translatable to the older patient?

      Over the last 30 years, the evolution of multimodal therapy for locally advanced rectal cancer (LARC) using neoadjuvant chemoradiotherapy and total mesorectal excision has resulted in substantial reductions in rates of local recurrence. [
      • Sauer R.
      • Liersch T.
      • Merkel S.
      • Fietkau R.
      • Hohenberger W.
      • Hess C.
      • et al.
      Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years.
      ] However, this success has not been paralleled by a reduction in distant recurrence with metastases developing in approximately a third of patients, resulting in death in most cases. [
      • Sauer R.
      • Liersch T.
      • Merkel S.
      • Fietkau R.
      • Hohenberger W.
      • Hess C.
      • et al.
      Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years.
      ,
      • Azria D.
      • Doyen J.
      • Jarlier M.
      • Martel-Lafay I.
      • Hennequin C.
      • Etienne P.
      • et al.
      Late toxicities and clinical outcome at 5years of the ACCORD 12/0405-PRODIGE 02 trial comparing two neoadjuvant chemoradiotherapy regimens for intermediate-risk rectal cancer.
      ]

      Keywords

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