Executive Summary of the ARS Appropriate Use Criteria for Local Excision in Rectal Cancer

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International journal of radiation oncology, biology, physics


The goal of treatment for early stage rectal cancer is to optimize oncologic outcome while minimizing impact of treatment on quality of life. The standard of care treatment for most early rectal cancers is radical surgery alone. Given the morbidity associated with radical surgery, local excision for early rectal cancers has been explored as an alternative approach associated with lower rates of morbidity. The American Radium Society Appropriate Use Criteria (ARS AUC) presented in this manuscript are evidence-based guidelines for the use of local excision in early stage rectal cancer that includes an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by a multidisciplinary expert panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. These guidelines are intended for the use of all practitioners and patients who desire information regarding the use of local excision in rectal cancer.

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ePub ahead of print