Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.7
3.0
Journals
JCM
Special Issues
Comprehensive Treatment of Rectal Cancer
jcm-logo
Submit to JCM Review for JCM Propose a Special Issue

Journal Menu

► Journal Menu

Journal Browser

► Journal Browser
share announcement

Comprehensive Treatment of Rectal Cancer

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 4943

Special Issue Editor

Dr. Jacopo Giuliani

E-Mail Website
Guest Editor
Department of Oncology, Azienda ULSS 9 Scaligera, Legnago, Italy
Interests: gastrointestinal cancers; randomized controlled trials; pharmacoeconomics; colorectal cancer; rectal cancer

Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) is a significant healthcare burden worldwide.

Globocam estimates the burden of CRC will increase to 3.2 million new cases and 1.6 million deaths by 2040. Treating locally advanced diseases, especially those in the rectum, is subject to debate. Traditionally, surgical resection has been the cornerstone of treatment for rectal cancer. However, the treatment paradigm has evolved in these years. In 2000, a meta-analysis showed that preoperative radiotherapy significantly improved overall survival (OS) compared with surgery alone, leading to the widespread adoption of this approach as a standard treatment. Also, it is proved that therapeutic effects can be ameliorated by associating chemotherapy with radiotherapy. The goals of chemoradiotherapy in rectal cancer should increase the results obtained with radiotherapy (downstage the tumour, the likelihood of sphincter preservation, and local tumour control) and reduce the risk of distant metastasis and more impacting (OS) outcomes. Surgical techniques had also evolved to improve the outcomes of these patients, although only recently these improvement are been standardized. Introducing the total mesorectal excision (TME) technique dramatically improved local recurrence-free survival.

The gold-standard treatment is a neoadjuvant approach with long term radiotherapy, fluoropyrimidine, and TME surgery. With the golden standard treatment, less than 5% of patients will have a local recurrence disease, but a stable rate of patients will have distant metastasis, with data at five years of 32%. Even today, the optimal management of rectal cancer remains a subject of ongoing research. Especially several attempts were made to evaluate the impact of chemotherapy-only treatment to reduce side effects on disease free survival (DFS) and OS. To this it is added the microsatellite instability-high locally advanced rectal cancer and the combination of immune checkpoint inhibitors with preoperative chemoradiotherapy. Considering all and thinking about the landscape of systemic treatments in the following years, an accurate estimate of DFS and OS rates in this group of patients is essential. Changing the natural history of rectal cancer is the only way to increase survival. 

This Special Issue of the Journal aims to comprehensively evaluate the developments in locally advanced rectal cancer treatment (surgery, radiotherapy, chemotherapy, immunotherapy) in order to optimize treatment strategies and improve long-term survival outcomes in these patients through to the collaboration of the specialists involved in rectal cancer treatment.

Dr. Jacopo Giuliani
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • rectal cancer
  • surgery
  • chemoradiotherapy
  • neoadjuvant therapy
  • radiotherapy
  • chemotherapy
  • microsatellite instability-high
  • immunotherapy

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Review

Jump to: Other

26 pages, 1237 KiB  
Review
Therapeutic Management of Locally Advanced Rectal Cancer: Existing and Prospective Approaches
by Horia-Dan Lișcu, Nicolae Verga, Dimitrie-Ionuț Atasiei, Andreea-Teodora Ilie, Maria Vrabie, Laura Roșu, Alexandra Poștaru, Stefania Glăvan, Adriana Lucaș, Maria Dinulescu, Andreea Delea and Andreea-Iuliana Ionescu
J. Clin. Med. 2025, 14(3), 912; https://doi.org/10.3390/jcm14030912 - 30 Jan 2025
Cited by 1 | Viewed by 1793
Abstract
Rectal cancer (RC) presents significant challenges in diagnosis and treatment, with increasing incidence among younger populations. Treatment approaches, particularly for locally advanced rectal cancer (LARC), have evolved, notably with the introduction of total neoadjuvant therapy (TNT). TNT combines neoadjuvant chemotherapy and chemoradiotherapy before [...] Read more.
Rectal cancer (RC) presents significant challenges in diagnosis and treatment, with increasing incidence among younger populations. Treatment approaches, particularly for locally advanced rectal cancer (LARC), have evolved, notably with the introduction of total neoadjuvant therapy (TNT). TNT combines neoadjuvant chemotherapy and chemoradiotherapy before surgery, improving overall survival and reducing both metastasis and local recurrence rates compared to traditional methods, while enabling more patients to complete the full oncological treatment. Clinical trials, such as RAPIDO, OPRA, and PRODIGE 23, have demonstrated the effectiveness of TNT in tumor downstaging and complete pathological responses, offering better outcomes for patients; however, debates persist regarding the role of neoadjuvant radiotherapy, with novel strategies exploring its omission in specific cases to reduce toxicity and enhance quality of life. In addition, organ preservation strategies, such as the watch-and-wait (WW) approach, have emerged as viable options for patients with a complete response to neoadjuvant therapy. Future directions point towards personalized treatment plans incorporating radiogenomics and the integration of artificial intelligence into diagnostics to optimize patient outcomes. This review aims to synthesize current treatment strategies and ongoing advancements in rectal cancer management, providing insights into potential future innovations. Full article
(This article belongs to the Special Issue Comprehensive Treatment of Rectal Cancer)
►▼ Show Figures

Graphical abstract

18 pages, 713 KiB  
Review
Total Mesorectal Excision with New Robotic Platforms: A Scoping Review
by Francesco Marchegiani, Carlo Alberto Schena, Gaia Santambrogio, Emilio Paolo Emma, Ivan Tsimailo and Nicola de’Angelis
J. Clin. Med. 2024, 13(21), 6403; https://doi.org/10.3390/jcm13216403 - 25 Oct 2024
Viewed by 1310
Abstract
Colorectal surgery is one of the specialties that have significantly benefited from the adoption of robotic technology. Over 20 years since the first robotic rectal resection, the Intuitive Surgical Da Vinci system remains the predominant platform. The introduction of new robotic systems into [...] Read more.
Colorectal surgery is one of the specialties that have significantly benefited from the adoption of robotic technology. Over 20 years since the first robotic rectal resection, the Intuitive Surgical Da Vinci system remains the predominant platform. The introduction of new robotic systems into the market has enabled the first documented total mesorectal excision (TME) using alternative platforms. This scoping review aimed to assess the role and adoption of these emerging robotic systems in performing TME for rectal cancer surgery. Methods: A comprehensive search of the Medline, Embase, and Cochrane databases was conducted up to August 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Results: Thirty-six studies were included in the review. The majority of rectal surgical procedures were performed using eight different robotic platforms. Intraoperative, short-term, and functional outcomes were generally favorable. However, pathological results were frequently incomplete. Several studies identified the lack of advanced robotic instruments as a significant limitation. Conclusions: The quality of the resected specimen is critical in rectal cancer surgery. Although TME performed with new robotic platforms appears to be feasible and safe, the current body of literature is limited, particularly in the assessment of pathological and long-term survival outcomes. Full article
(This article belongs to the Special Issue Comprehensive Treatment of Rectal Cancer)
►▼ Show Figures

Figure 1

Other

Jump to: Review

15 pages, 1249 KiB  
Systematic Review
Oral Bisphosphonates for Colorectal Cancer Prevention: A Meta-Analytic Reappraisal Beyond Bone Health
by Enrico Altiero Giusto, Rossella Donghia, Carlotta Giorgi, Paolo Pinton and Francesco Fiorica
J. Clin. Med. 2025, 14(11), 3702; https://doi.org/10.3390/jcm14113702 (registering DOI) - 25 May 2025
Abstract
Background: Oral bisphosphonates (BPs) are the standard therapy for osteoporosis and skeletal metastases, and exhibit anti-tumor properties in preclinical models. Observational studies assessing their impact on colorectal cancer (CRC) risk have yielded inconsistent results. We aimed to systematically review and meta-analyze the association [...] Read more.
Background: Oral bisphosphonates (BPs) are the standard therapy for osteoporosis and skeletal metastases, and exhibit anti-tumor properties in preclinical models. Observational studies assessing their impact on colorectal cancer (CRC) risk have yielded inconsistent results. We aimed to systematically review and meta-analyze the association between oral bisphosphonate use and CRC risk, applying a unified exposure definition. Methods: A systematic search was conducted in PubMed, Embase, and Scopus (January 1966–April 2025) to identify cohort, nested case–control, or population-based case–control studies reporting adjusted estimates of relative risk, odds ratios (ORs), or hazard ratios (HRs) for CRC among oral bisphosphonate users. Two reviewers independently screened studies, extracted data, and assessed quality using the Newcastle–Ottawa Scale. Random-effects meta-analyses pooled risk estimates for “any use” of bisphosphonates, with subgroup analyses by duration of use (<1, 1–3, >3 years). We assessed publication bias through Egger’s test and the trim-and-fill method. Results: A total of eight studies published between 2010 and 2020, including 29,169 CRC cases, fulfilled the inclusion criteria. Any bisphosphonate use was not significantly associated with CRC risk (pooled OR 0.97; 95% C.I., 0.90–1.03). However, 1–3 years of use conferred a protective effect (OR 0.86; 95% C.I., 0.73–0.99), as did >3 years (OR 0.91; 95% C.I., 0.85–0.97). Heterogeneity was moderate, and no significant publication bias was detected. Conclusions: While overall oral bisphosphonate exposure is not significantly linked to CRC risk, prolonged use (≥1 year) appears to reduce risk. Prospective studies and randomized trials are needed to confirm these chemo-preventive effects and guide clinical recommendations. Full article
(This article belongs to the Special Issue Comprehensive Treatment of Rectal Cancer)
►▼ Show Figures

Figure 1

9 pages, 596 KiB  
Systematic Review
“Defendit Numerus”: A Pooled Analysis of 6145 Locally Advanced Rectal Cancer Treated with Preoperative Chemoradiotherapy
by Jacopo Giuliani, Marta Mandarà, Marco Muraro, Elvira Rampello, Antonella Franceschetto and Francesco Fiorica
J. Clin. Med. 2024, 13(18), 5456; https://doi.org/10.3390/jcm13185456 - 14 Sep 2024
Cited by 1 | Viewed by 1318
Abstract
Objective: The optimal management of rectal cancer remains a subject of ongoing research. This meta-analysis of individual patient data assessed the benefit of chemoradiotherapy (fluorouracil-based) in local advanced rectal cancer: disease-free survival and overall survival. Methods: We pooled the data of 6145 patients [...] Read more.
Objective: The optimal management of rectal cancer remains a subject of ongoing research. This meta-analysis of individual patient data assessed the benefit of chemoradiotherapy (fluorouracil-based) in local advanced rectal cancer: disease-free survival and overall survival. Methods: We pooled the data of 6145 patients from 24 studies of rectal cancer who received neoadjuvant radiotherapy with concomitant fluorouracil or capecitabine and surgery. The PRISMA 2020 abstract checklist was followed. Individual participant survival was reconstructed with an algorithm from published Kaplan–Meier curves. Results: The median OS was not reached; the mean survival time was 135.4 months (127.9–141.5). The median DFS was 176.9 months, and the mean disease-free survival time was 122.6 months (111.7–131.9). Conclusions: We provided a benchmark for future studies on rectal cancer treatment. The present results can be used in decision-making for locally advanced rectal cancer patients. Full article
(This article belongs to the Special Issue Comprehensive Treatment of Rectal Cancer)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-4
Back to TopTop