Lack of Complete Pretreatment Staging Is Associated with Omission of Neoadjuvant Therapy for Rectal Cancer: A Statewide Study

“Surgeons and other physicians must consistently recognize when a patient has mid-to-low RC and should perform local RC staging for these cases. This includes pelvic MRI or endorectal ultrasound (ERUS), from which the clinical T-stage and N-stage are derived for treatment decision-making.”

Standardized local staging and neoadjuvant therapy are rectal cancer management quality measures supported by the Commission on Cancer and the National Accreditation Program for Rectal Cancer for the management of rectal cancer. 

Previous studies suggested that up to 25% of patients with stage II/III rectal cancer patients do not receive neoadjuvant therapy. This article hypothesizes that failure to receive neoadjuvant therapy may be caused by failure to properly stage patients before surgery.

This study shows that neoadjuvant therapy for stage II/III RC continues to be underused. Furthermore, omission of NT is associated with failure to stage RC with MRI/ERUS.