top of page


  1. Amin MB, Edge SB, Greene FL, et al, eds. AJCC Cancer Staging Manual. 8th ed. New York: Springer; 2017.

  2. Bedenne L., Michel P., Bouche O., et al: Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus. FFCD 9102. J. Clin. Oncol. 2007; 25: pp. 1160-1168).

  3. Burmeister B.H., Thomas J.M., Burmeister E.A., et al: Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial. Eur J Cancer 2011; 47: pp. 354-360.

  4. Cooper JS, Guo MD, Herskovic A, Macdonald JS, Martenson JA Jr, Al-Sarraf M, Byhardt R, Russell AH, Beitler JJ, Spencer S, Asbell SO, Graham MV, Leichman LL.  Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group. JAMA. 1999 May 5;281(17):1623-7.

  5. Cunningham D., Allum W.H., Stenning S.P., et al: Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006; 355: pp. 11-20.

  6. Francis A.M., Sepesi B., Correa A.M., et al: The influence of histopathologic tumor viability on long-term survival and recurrence rates following neoadjuvant therapy for esophageal adenocarcinoma. Ann Surg 2013; 258: pp. 500-507.

  7. Kelsen D.P., Winter K.A., Gunderson L.L., et al: Long-term results of RTOG trial 8911 (USA Intergroup 113): A randomassignment trial comparison of chemotherapyfollowedbysurgerycomparedwithsurgeryaloneforesophagealcancer. J Clin Oncol 2007; 25: pp. 3719-3725.

  8. Mariette C, Dahan L, Mornex F, Maillard E, Thomas PA, Meunier B, Boige V, Pezet D, Robb WB, Le Brun-Ly V, Bosset JF, Mabrut JY, Triboulet JP, Bedenne L, Seitz JF. Surgery alone versus chemoradiotherapy followed by surgery for stage I and II esophageal cancer: final analysis of randomized controlled phase III trial FFCD 9901. J ClinOncol. 2014 Aug 10;32(23):2416-22.

  9. Medical Research Council Oesophageal Cancer Working Group. Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomized controlled trial. Lancet. 2002 May 18;359(9319):1727-33.

  10. Napier KJ, Scheerer M, Misra S. Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities. World J Gastrointest Oncol. 2014;6(5):112-20. PubMed PMID: 24834141.

  11. NCCN guidelines 2018 for treatment cancer by site. Acceso online:

  12. Shapiro J., van Lanschot J.J., Hulshof M.C., and van der Gaast A.: Effectiveness of neoadjuvant chemoradiotherapy for early-stage esophageal cancer. J. Clin. Oncol. 2015 Jan; 20: pp. 288-289.

  13. Shapiro J., van Lanschot J.J., Hulshof M.C., et al: Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): Long-term results of a randomized controlled trial. Lancet Oncol 2015; 16: pp. 1090-1098.

  14. Stahl M., Stuschke M., Lehmann N., et al: Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus. J. Clin. Oncol. 2005; 23: pp. 2310-2317.

  15. Stahl M., Walz M.K., Stuschke M., et al: Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J ClinOncol 2009 27: pp. 851-856)

  16. Swisher SG, Moughan J, Komaki RU, Ajani JA, Wu TT, Hofstetter WL, Konski AA, Willett CG. Final Results of NRG Oncology RTOG 0246: An Organ-Preserving Selective Resection Strategy in Esophageal Cancer Patients Treated with Definitive Chemoradiation. J ThoracOncol.2017 Feb;12(2):368-374.

  17. Toxopeus E, van der Schaaf M, van Lanschot J, Lagergren J, Lagergren P, van der Gaast A, Wijnhoven B. Outcome of Patients Treated Within and Outside a Randomized Clinical Trial on Neoadjuvant Chemoradiotherapy lusurgery for Esophageal Cancer: Extrapolation of a Randomized Clinical Trial (CROSS). Ann SurgOncol. 2018 Aug;25(8):2441-2448.

  18. Yang H, Liu H, Chen Y, et al. Neoadjuvant Chemoradiotherapy Followed by Surgery Versus Surgery Alone for Locally Advanced Squamous Cell Carcinoma of the Esophagus (NEOCRTEC5010): A Phase III Multicenter, Randomized, Open-Label Clinical Trial. J ClinOncol. 2018;36(27):2796-2803.

  19. Sabiston. Tratado de cirugía, Capítulo 41, 1014-1042. Tratado de cirugía. 20.ª Edición. Copyright © 2018 Elsevier España, S.L.U.

  20. Chiappa A, Andreoni B, Dionigi R, Spaggiari L, Foschi D, Polvani G, OrecchiaR, Fazio N, ravettoni G, Cossu ML, Galetta D, Venturino M, Ferrari C, Macone L, Crosta C, Bonanni B, Biffi. A rationale multidisciplinary approach fortreatment of esophageal and gastroesophageal junction cancer: Accurate review of management and perspectives. Crit Rev OncolHematol.2018 Dec; 132:161-168.





  1.  Siegel et al. CA Cancer J Clin. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. Epub 2019 Jan

  2.  De Angelis R, et al. 2014; Base de datos EUROCARE.

  3.  Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery. The clue to pelvic recurrence? Br J Surg 1982; 69: 613-616.

  4.  Hamilton SR, Aaltonen LA: Pathology and Genetics of Tumours of the Digestive System. Lyon, France: International Agency for Research on Cancer, 2000.

  5.  Palefsky JM, Holly EA, Gonzales J, et al. Detection of human papillomavirus DNA in anal intraepithelial neoplasia and anal cancer. Cancer Res 51 (3): 1014-9, 1991.

  6.  Baxter NN, Tepper JE, Durham SB et al. Increased risk of rectal cancer after prostate radiation: a population-based study. Gastroenterology 2005; 128:819-824.

  7.  Bali C, Nousias V, Fatouros M, Stefanou D, Kappas AM. Assessment of local stage in rectal cancer using endorectal ultrasonography (EUS). Tech Coloproctol 2004;8 Suppl 1: s 170-3.

  8.  Chand M, Palmer T, Blomqvist L, Nagtegaal I, West N, Brown G. Evidence for radiological and histopathological prognostic importance of detecting extramural venous invasion in rectal cancer: recommendations for radiology and histopathology reporting. Colorectal Dis. 2015 Jun;17(6):468-73.

  9.  Battersby NJ, Moran B, Yu S, Tekkis P, Brown G. MR imaging for rectal cancer: the role in staging the primary and response to neoadjuvant therapy. Expert Rev Gastroenterol Hepatol. 2014 Aug;8(6):703-19.

  10.  Videhult P, Smedh K, Lundin P, Kraaz W. Magnetic resonance imaging for preoperative staging of rectal cancer in clinical practice: high accuracy in predicting circumferential margin with clinical benefit. Colorrectal Dis 2007;9(5):412-9.

  11.  Purkayastha S, Tekkis PP, Athanasiou T, Tilney HS, Darzi AW, Heriot AG. Diagnostic precision of magnetic resonance imaging for preoperative prediction of the circumferential margin involvement in patients with rectal cancer. Colorrectal Dis 2007; 9(5):402-11

  12.  Withofs N, Bernard C, Van der Rest C, Martinive P, Hatt M, Jodogne S, Visvikis D, Lee JA, Coucke PA, Hustinx R. FDG PET/CT for rectal carcinoma radiotherapy treatment planning: comparison of functional volume delineation algorithms and clinical challenges. J Appl Clin Med Phys. 2014 Sep 8;15(5):4696.

  13.  Mellgren A, Sirivongs P, Rothenberger DA, Madoff RD, Garcia-Aguilar J. Is local excision adequate therapy for early rectal cancer? Dis Colon Rectum 2000;43(8):1064-71; discussion 1071-4.

  14.  Fang WL, Chang SC, Lin JK, Wang HS, Yang SH, Jiang JK, et al. Metastatic potential in T1 and T2 colorrectal cancer. Hepatogastroenterology 2005;52(66):1688-91.

  15.  Lezoche E, Guerrieri M et al. Long-term results in patients with T2-3 N0 distal rectal cancer undergoing radiotherapy before transanal endoscopic microsurgery. Br J Surg 2005;92(12):1546-52.

  16.  Nelson H, Petrelli N, Carlin A, et al. Guidelines 2000 for colon and rectal cáncer surgery. J Natl Cancer Inst 2001; 93:583.

  17.  Rajput A, Romanus D, Weiser MR, et al. Meeting the 12 lymph node (LN) benchmark in colon cancer. J Surg Oncol 2010; 102:3.

  18.  Compton CC, Fielding LP, Burgart LJ, et al. Prognostic factors in colorrectal cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 2000; 124:979.

  19.  Tepper JE, O'Connell MJ, Niedzwiecki D, et al. Impact of number of nodes retrieved on outcome in patients with rectal cancer. J Clin Oncol 2001; 19:157.

  20.  Vernava AM 3rd, Moran M, Rothenberger DA, Wong WD. A prospective evaluation of distal margins in carcinoma of the rectum. Surg Gynecol Obstet 1992; 175:333.

  21.  Nash GM, Weiss A, Dasgupta R, et al. Close distal margin and rectal cancer recurrence after sphincter preserving rectal resection. Dis Colon Rectum 2010; 53:1365.

  22.  Wolmark N, Fisher B. An analysis of survival and treatment failure following abdominoperineal and sphincter-saving resection in Dukes' B and C rectal carcinoma. A report of the NSABP clinical trials. National Surgical Adjuvant Breast and Bowel Project. Ann Surg 1986; 204:480.

  23.  Nagtegaal ID, Quirke P. What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol 2008; 26:303.

  24.  De Haas-Kock DF, Baeten CG, Jager JJ, et al. Prognostic significance of radial margins of clearance in rectal cancer. Br J Surg 1996; 83:781.

  25.  Hall NR, Finan PJ, al-Jaberi T et al. Circumferential margin involvement after mesorectal excision of rectal cancer with curative intent. Predictor of survival but not local recurrence? Dis Colon Rectum 1998; 41:979.

  26.  Arbman G, Nilsson E, Hallböök O, Sjödahl R. Local recurrence following total mesorectal excision for rectal cancer. Br J Surg 1996; 83:375.

  27.  Scott N, Jackson P, al-Jaberi T, et al. Total mesorectal excision and local recurrence: a study of tumour spread in the mesorectum distal to rectal cancer. Br J Surg 1995; 82:1031.

  28.  Marinello F, Frasson M et al. Selective approach for upper rectal cancer treatment: total mesorectal excision and preoperative chemoradiation are seldom necessary. Diseases of the Colon and Rectum. Vol 58:6. 2015

  29. National Cancer Institute Clinical Announcement. Adjuvant Therapy of Rectal Cancer. National Cancer Institute, 1991

  30. Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJ, Pahlman L, Glimelius B, van Krieken JH, Leer JW, van de Velde CJ; Dutch Colorrectal Cancer  Group. Preoperative Radiotherapy Combined with total mesorectal Escisión for Resecable Rectal Cancer. NEJM 345:638-646, 2001.

  31. Cammà C, Giunta M, Fiorica F, Pagliaro L, Craxì A, Cottone M Preoperative radiotherapy for resectable rectal cancer: A meta-analysis. JAMA. 2000 Aug 23-30;284(8):1008-15.

  32. Figueredo A, Zuraw L, Wong RK, Agboola O, Rumble RB, Tandan V; Cancer Care Ontario's Program in Evidence-based Care's Gastrointestinal Cancer Disease Site Group. The use of preoperative radiotherapy in the management of patients with clinically resectable rectal cancer: a practice guideline. BMC Med. 2003 Nov 24;1: 1. Review.

  33. Colorectal Cancer Collaborative Group. Adjuvant radiotherapy for rectal cancer: a systematic overview of 8,507 patients from 22 randomised trials. Lancet. 2001 Oct 20; 358(9290):1291-304.

  34. Felipe Calvo y col. Pathologic Downstaging of T3-4 Nx Rectal Cancer after chemoradiation: 5-FU vs. Tegafur. Int J Rad Onc Biol Phys 51, 5: 1264-1270, 2001.

  35. Minsky BD, Cohen AM, Kemeny N, Enker WE, Kelsen DP, Reichman B, Saltz L, Sigurdson ER, Frankel J. Enhancement of radiation induced downstaging of rectal cancer by fluorouracil and high-dose leucovorin chemotherapy. J. Clin Oncol 10:79-84, 1992.

  36. Ota DM, Jacobs L, Kuvshinoff B. Rectal cancer: the sphincter-sparing approach. Surg Clin North Am. 2002 Oct; 82(5):983-93.

  37. Boris Kuvshinoff Distal Margin Requirements After Preoperative Chemoradiotherapy for Distal Rectal Carcinomas: Are 1 cm Distal Margins Sufficient? Annals of Surgical Oncology 8:163-169 (2001).

  38. S. Roels, W. Duthoy, K. Haustermans, F. Penninckx, V. Vandecaveye,  T.Boterberg, W. De Neve. Definition and Delineation of the Clinical Target Volume for Rectal Cancer. I.J. Radiation Oncology Biol. Phys., Vol. 65, No. 4, pp. 1129–1142, 2006.

  39. R Myerson, M Garofalo, I el Naqa , R Abrams , A Apte , W Bosch , P Das , L Gunderson, T Hong , J Kim , C Willett , L Kachnic. Elective Clinical Target Volumes in Anorectal Cancer: An RTOG Consensus Panel Contouring Atlas. Int J Radiat Oncol Biol Phys. Jul 1;74(3):824-30 2009

  40. Valentini V et al. International consensus guidelines on Clinical Target Volume delineation in rectal cancer. Radiotherapy and Oncology 120 (2016) 195–201

  41. Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991 May 15; 21(1):109-22.

  42. O'Connell MJ, Martenson JA, Wieand HS, Krook JE, Macdonald JS, Haller DG, et al. Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med 1994; 331(8):502-7.

  43. Hofheinz R, Wenz FK, Post S, et al. Capecitabine (Cape) versus 5-fluorouracil (5-FU)–based (neo) adjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC): Long-term results of a randomized, phase III trial. J Clin Oncol 2011;29 (suppl):3504.

  44. Fernandez-Martos C, Brown G, Estevan R, Salud A, Montagut C, Maurel J, Safont MJ, Aparicio J, Feliu J, Vera R, Alonso V, Gallego J, Martin M, Pera M, Sierra E, Serra J, Delgado S, Roig JV, Santos J, Pericay C. Preoperative chemotherapy in patients with intermediate-risk rectal adenocarcinoma selected by high-resolution magnetic resonance imaging: the GEMCAD 0801 Phase II Multicenter Trial. Oncologist. 2014 Oct; 19(10):1042-3. doi: 10.1634/theoncologist.2014-0233. Epub 2014 Sep 10.

  45. Fernandez-Martos C, Garcia-Albeniz X, Pericay C, Maurel J, Aparicio J, Montagut C, Safont MJ, Salud A, Vera R, Massuti B, Escudero P, Alonso V, Bosch C, Martin M, Minsky BD. Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trial†. Ann Oncol. 2015 Aug; 26(8):1722-8. doi: 10.1093/annonc/mdv223. Epub 2015 May 8.


  47. Goodman K et al. Appropriate Customization of Radiation Therapy for Stage II and III Rectal Cancer: An ASTRO Clinical Practice Statement Using the RAND/UCLA Appropriateness Method. Pract Radiat Oncol. 2016 May-Jun;6(3):166-175. doi: 10.1016/j.prro.2015.11.014. Epub 2015 Nov 24.



  50. Babei M et al. Neoadjuvant Therapy in Rectal Cancer Patients With Clinical Stage II to III Across European Countries: Variations and Outcomes Clin Colorectal Cancer. 2018 Mar; 17(1): e129–e142.

  51. Cercek A et al. Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer JAMA Oncol. 2018;4(6): e180071. doi:10.1001/jamaoncol.2018.0071

  52. Breugom AJ, et al. Adjuvant chemotherapy for rectal cancer patients treated with preoperative (chemo)radiotherapy and total mesorectal excision: a Dutch Colorectal Cancer Group (DCCG) randomized phase III trial. Ann Oncol. 2015; 26:696-701.

  53. Hong T. Short-Course Versus Standard Chemoradiation in T3 Rectal Cancer The Oncologist May 2011 vol. 16 no. 5 717-721

  54. Roy, Amit et al Preoperative short-course radiation therapy for rectal cancer provides excellent disease control and toxicity: Results from a single US institution. Practical Radiation Oncology , Volume 7, Issue 1 , e51 - e58

  55. Skóra T et al. Preoperative short-course radiotherapy in rectal cancer patients: results and prognostic factors J Radiat Oncol. 2018; 7(1): 77–84.

  56. Chen K, Xie G, Zhang Q, Shen Y, Zhou T. Comparison of short-course with long-course preoperative neoadjuvant therapy for rectal cancer: A meta-analysis. J Can Res Ther 2018;14, Suppl S1:224-31

  57. Wang X, Zheng B, Lu X, et al. Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data. PLoS One. 2018;13(7): e0200142. Published 2018 Jul 12. doi:10.1371/journal.pone.0200142

  58. Erlandsson J; Holm T; Pettersson D et al. Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a randomised controlled trial. Lancet Oncol. 2017; 18: 336-346

  59. Wu H, Fang C et al. Short-course radiotherapy with immediate or delayed surgery in rectal cancer: A meta-analysis Int J Surg. 2018 Aug;56:195-202. doi: 10.1016/j.ijsu.2018.05.031. Epub 2018 May 25.

  60. Aghili M et al. Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results. Radiation Oncology Journal 2018; 36(1): 17-24. DOI:

  61. Glynne-Jones R, Wyrwicz L et al.  Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul 1;28(suppl_4) Iv 22-iv40. doi: 10.1093/annonc/mdx224.

  62. Cassidy RJ et al. Can we eliminate neoadjuvant chemoradiotherapy in favor of neoadjuvant multiagent chemotherapy for select stage II/III rectal adenocarcinomas: Analysis of the National Cancer Data base. Cancer.  2017; 123(5):783 793 

  63. Wang, X. et al. Adjuvant Radiation Therapy May Be Necessary for High-Risk Patients With Stage II or III Upper Rectal Cancer After Total Mesorectal Excision. IJROBP, Volume 90, Issue 1, S382 - S383

  64. Hai-hua Peng, Xin-hui Zhou, Tong-chong Zhou, Tumor location as an indication for adjuvant radiotherapy in pT3N0 rectal cancer after surgery Radiation Oncology, 2019, Volume 14, Number 1, Page 1

  65. Breugom AJ et al. Adjuvant chemotherapy after preoperative (chemo)radiotherapy and surgery for patients with rectal cancer: a systematic review and meta-analysis of individual patient data. Lancet Oncol. 2015 Feb;16(2):200-7. doi: 10.1016/S1470-2045(14)71199-4. Epub 2015 Jan 12.

  66. Bregom AJ et al. Adjuvant chemotherapy for rectal cancer patients treated with preoperative (chemo)radiotherapy and total mesorectal excision: a Dutch Colorectal Cancer Group (DCCG) randomized phase III trial, Annals of Oncology, Volume 26, Issue 4, April 2015, Pages 696 701,




1. NCCN guidelines 2018 for treatment cancer by site. Acceso online:

2. ICO-ICS Páncreas. Acceso online: 3. Ministerio de Sanidad y Política Social. Estrategia en Cáncer del Sistema Nacional de Salud. Minist Sanid y Política Soc. 2010;1-172. Disponible en:

4.Katz MH, Crane CH,  Varadhachary G. Management of borderline resectable pancreatic cancer. Semin Radiat Oncol. 2014 Apr;24(2):105-12.

5. Le Scodan R, Mornex F, Girard N, Mercier C, Valette PJ, Ychou M, Bibeau F, Roy P, Scoazec JY, Partensky C. Preoperative chemoradiation in potentially resectable pancreatic adenocarcinoma: feasibility, treatment effect evaluation and prognostic factors, analysis of the SFRO-FFCD 9704 trial and literature review. Ann Oncol. 2009 Aug;20(8):1387-96

6. Papalezova KT, Tyler DS, Blazer DG 3rd, Clary BM,  Czito BG , Hurwitz HI,  Uronis HE , Pappas TN, Willett CG, White RR. Does preoperative therapy optimize outcomes in patients with resectable pancreatic cancer? J Surg Oncol. 2012 Jul 1;106(1):111-8

7. Ueno H, Kosuge T, Matsuyama Y, Yamamoto J, Nakao A, Egawa S, et al. A randomised phase III trial comparing gemcitabine with surgery-only in patients with resected pancreatic cancer: Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer. Br J Cancer. 2009;

8. Neoptolemos JP, Palmer DH, Ghaneh P, Psarelli EE, Valle JW, Halloran CM, et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancet. 2017;

9. Chang DK, Johns AL, Merrett ND, Gill AJ, Colvin EK, Scarlett CJ, et al. Margin Clearance and Outcome in Resected Pancreatic Cancer. J Clin Oncol. 2009;27(17):2855-62.

10. Balaban EP, Mangu PB, Khorana AA, Shah MA, Mukherjee S, Crane CH, et al. Locally advanced, unresectable pancreatic cancer: American society of clinical oncology clinical practice guideline. J Clin Oncol. 2016;34(22):2654-67.

​11. Wolny-Rokicka E, Sutkowski K, Grządziel A, Dorsz Ż, Tukiendorf A, Lipiński J, et al. Tolerance and efficacy of palliative radiotherapy for advanced pancreatic cancer: A retrospective analysis of single-institutional experiences. Disponible en

bottom of page