8
Treatment
Table 8. Rectal Cancer Stage IIA– clinical stage T3 N0
Population Intervention Setting
Patients with clinically
resectable cT3N0
rectal cancer
Multidisciplinary teams should base decisions
regarding neoadjuvant therapy (CRT or SCPRT)
on preoperative, MRI-predicted CRM (1mm),
EMVI and more advanced T3 substages (T3c/
T3d), which define the risk of both local
recurrence and/or synchronous and subsequent
metastatic disease. (Strong Recommendation; H)
Enhanced
and
Maximal
Patients with clinically
resectable pT3N0
rectal cancer at high
risk who had surgery
and did not receive
neoadjuvant treatment
Medical oncologists may offer chemoradiation.
(Strong Recommendation; H)
Enhanced
Patients with clinically
resectable cT3N0
rectal cancer
Treatment decisions regarding neoadjuvant
therapy (CRT or SCPRT) should be based on
preoperative, MRI-predicted CRM (1mm),
EMVI and more advanced T3 substages (T3c/
T3d), which define the risk of both local
recurrence and/or synchronous and subsequent
metastatic disease. (Strong Recommendation; H)
Maximal
Patients with clinically
resectable cT3N0
rectal cancer, high-risk
stage II rectal cancer,
and all patients with
stage III rectal cancer
Medical oncologists should assess pathologic
stage aer surgery and should offer adjuvant
chemotherapy to reduce the risk of local and
systemic recurrence.
(Strong Recommendation; H)
Maximal
(cont'd)
Table 9. Early-Stage Colon Cancer Post-Treatment
Surveillance
Population Intervention Setting
Treated patients with
Stage II CRC
Medical history, physical exam every 6 months
for minimum 3 years. CEA every 6 months for
minimum 3 years if available. Chest x-ray and
abdominal ultrasound twice in the first 3 years.
Colonoscopy once in the first 1–2 years aer
surgery (if colonoscopy available in local or
referral setting ). If colonoscopy is unavailable,
may perform a double contrast barium enema
and/or for le-sided tumors a sigmoidoscopy.
(Weak Recommendation; L)
Basic
