Is there a role for total neoadjuvant treatment in early-stage rectal cancer?

Cohort studyLangenbeck's archives of surgery· Nov 2025

Is there a role for total neoadjuvant treatment in early-stage rectal cancer?

Kamil Erozkan, Metincan Erkaya, Jacob A Miller … Emre Gorgun

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Colon & Rectal SurgeryCohort studyTreatmentQ1IF 2.2

Selective total neoadjuvant treatment achieved complete response in 93.7% of stage I rectal cancers

Is there a role for total neoadjuvant treatment in early-stage rectal cancer?

Kamil Erozkan … Emre Gorgun

Langenbeck's archives of surgery · Nov 2025 · Q1 in Surgery

Background

Current guidelines recommend surgical interventions for stage I rectal cancer (S1RC).

Methods

With S1RC who declined total mesorectal excision (total mesorectal excision) and opted for treatment between 2015 and 2023 were retrospectively reviewed.

n = 11

93.7%

Results

93.7%

Treatment achieved complete tumor response in nearly all patients

n = 11

More results

The study included sixteen S1RC patient (69% male) who underwent treatment.

Eleven patients received treatment following partial response, while the remaining underwent treatment after transanal full-thickness local excision.

In the first group (n = 11), nine patients achieved a complete clinical response.

More results

One patient with a near-complete response underwent endoscopic submucosal dissection, which revealed a tubulovillous adenoma.

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Conclusion · 1 of 2

Selective utilization of treatment in S1RC holds the potential to foster organ preservation, particularly for low rectal cancer.

Conclusion · 2 of 2

Larger prospective studies with longer follow-up and standardized treatment protocols are needed to validate these preliminary findings.

Is there a role for total neoadjuvant treatment in early-stage rectal cancer?

Is there a role for total neoadjuvant treatment in early-stage rectal cancer?

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