Technologies and approaches developed to tackle colorectal cancer
Surgery for colorectal cancer has been developed over time to improve the outcome, medical experts said during an academic meeting hosted by the Bangkok Dusit Medical Services (BDMS).
As techniques evolve, a focus on precision, organ preservation, and individualised care continues to drive progress, such as laparoscopic and robotic surgery that improve visualisation and manoeuvrability in narrow pelvic spaces.
Magnetic resonance imaging facilitates precise preoperative staging by identifying suspicious lymph nodes and delineating tumour boundaries. Total neoadjuvant therapy (TNT), which involves radiotherapy and chemotherapy prior to surgery, has improved the ability to shrink tumours, enabling more effective resections and preserving vital structures.
“Colorectal surgery remains the only curative approach for early-stage cases, achieving up to 95% of survival rates within five years,” said Vassiliki Liana Tsikitis, professor of surgery at the Oregon Health & Science University.
She added that chemotherapy and radiation therapy could help boost treatment outcomes among advanced-stage cases.
However, challenges in surgical management exist, including narrow pelvis, bulky tumours and high body mass index, all of which present difficulties in achieving clear circumferential margins.
Though robotic systems offer enhanced precision, particularly for challenging rectal surgeries, cost and availability remain limitations.
Outcomes are significantly influenced by the surgery and hospital care, with higher volumes correlating to improved survival and reduced complications, Tsikitis said.
Krittiya Korphaisarn, an oncologist at Mahidol University’s Faculty of Medicine Siriraj Hospital, said TNT enables physicians to address challenges in rectal cancer in advanced-stage cases, including incomplete treatment and lack of demonstrated survival benefit.
TNT demonstrates advantages in terms of higher pathological complete response rates, potential for improved compliance with systemic therapy, and early eradication of micrometastases.
However, challenges for this approach remain, including limited evidence of survival benefits compared to conventional treatments, higher toxicity and the need for individualised patient selection.
“The TNT approach holds significant promise for transforming rectal cancer management, emphasising early systemic control and improved treatment responses,” Krittiya said.
She added that continued research and clinical trials are essential to refine these strategies and establish long-term outcomes.
BDMS has organised its annual academic meetings for 19 consecutive years. This year’s event was held from November 18 to 22 at the BDMS Connect Centre in Bangkok, on the theme “A Road to Lifelong Well-Being Episode 2: Unlocking Healthy Longevity.”
The conference served as a platform for exchanging knowledge and expertise across various medical fields. This year’s theme was a reflection of global trends and addressed the evolving needs of today’s society, emphasising sustainable health and long-term well-being.
