Contemporary neoadjuvant strategies for rectal cancer: The GRECCAR snapshot study
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Wiley
2026
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| author | Antoine Cazelles Quentin Denost Benjamin Fernandez Michel Rivoire Hélène Meillat Philippe Rouanet Mehdi Karoui Adeline Germain Leon Maggiori Alain Valverde Nicolas Peru Eddy Cotte Etienne Buscail Jeremie H. Lefevre Bertrand Trilling Jean Luc Faucheron Pierre Yves Sage Laura Beyer‐Berjot Stephane Benoist Arnaud Alves Charles Sabbagh Jean‐Jacques Tuech Julien Coget Frédéric Marchal Guillaume Meurette Diane Mège Dahbia Djelil Simone Manfredelli Aurélien Venara Mehdi Ouaissi Gilles Manceau |
| author_facet | Antoine Cazelles Quentin Denost Benjamin Fernandez Michel Rivoire Hélène Meillat Philippe Rouanet Mehdi Karoui Adeline Germain Leon Maggiori Alain Valverde Nicolas Peru Eddy Cotte Etienne Buscail Jeremie H. Lefevre Bertrand Trilling Jean Luc Faucheron Pierre Yves Sage Laura Beyer‐Berjot Stephane Benoist Arnaud Alves Charles Sabbagh Jean‐Jacques Tuech Julien Coget Frédéric Marchal Guillaume Meurette Diane Mège Dahbia Djelil Simone Manfredelli Aurélien Venara Mehdi Ouaissi Gilles Manceau Antoine Cazelles Quentin Denost Benjamin Fernandez Michel Rivoire Hélène Meillat Philippe Rouanet Mehdi Karoui Adeline Germain Leon Maggiori Alain Valverde Nicolas Peru Eddy Cotte Etienne Buscail Jeremie H. Lefevre Bertrand Trilling Jean Luc Faucheron Pierre Yves Sage Laura Beyer‐Berjot Stephane Benoist Arnaud Alves Charles Sabbagh Jean‐Jacques Tuech Julien Coget Frédéric Marchal Guillaume Meurette Diane Mège Dahbia Djelil Simone Manfredelli Aurélien Venara Mehdi Ouaissi Gilles Manceau |
| collection | Wiley Open Access |
| contents | Contemporary neoadjuvant strategies for rectal cancer: The GRECCAR snapshot study Antoine Cazelles Quentin Denost Benjamin Fernandez Michel Rivoire Hélène Meillat Philippe Rouanet Mehdi Karoui Adeline Germain Leon Maggiori Alain Valverde Nicolas Peru Eddy Cotte Etienne Buscail Jeremie H. Lefevre Bertrand Trilling Jean Luc Faucheron Pierre Yves Sage Laura Beyer‐Berjot Stephane Benoist Arnaud Alves Charles Sabbagh Jean‐Jacques Tuech Julien Coget Frédéric Marchal Guillaume Meurette Diane Mège Dahbia Djelil Simone Manfredelli Aurélien Venara Mehdi Ouaissi Gilles Manceau Colorectal Disease Abstract Aim Neoadjuvant treatment for rectal cancer has evolved markedly with the growing adoption of total neoadjuvant therapy ( TNT ), organ‐preservation strategies and selective omission of radiotherapy. Recent trials support risk‐based personalization, but its application in real‐world settings remains poorly documented. The aim was to describe current neoadjuvant treatment practices for mid‐low rectal cancer in French expert centres and identify tumour‐ and patient‐related factors influencing decisions. Method This observational study included patients with non‐metastatic rectal adenocarcinoma ≤10 cm from the anal verge, discussed in tumour boards (October 2022 to March 2023) across GRECCAR centres. Tumours were classified as early, intermediate‐risk or locally advanced rectal cancer (LARC). Neoadjuvant treatments were analysed according to tumour extension, location and age. Results Among 463 patients from 27 centres, the most frequent regimen was induction chemotherapy, mainly FOLFIRINOX, followed by long‐course chemoradiotherapy (CRT) (65%). This approach was used in 51%, 66% and 71% of patients in the early, intermediate‐risk and LARC groups, respectively ( p = 0.0060). TNT was more frequently administered for low‐ than mid‐rectal cancers, especially in LARC (86% vs. 71%, p = 0.016). In patients >75 years, CRT + consolidation chemotherapy and radiotherapy alone were proportionally more frequent. Among the early rectal cancers, those treated with induction chemotherapy + CRT had more advanced features than those treated with CRT alone (cT3: 80% vs. 43%, cN+: 62% vs. 10%, tumour size: 3.4 vs. 2.3 cm; all p < 0.001). Conclusion TNT with induction chemotherapy is the predominant neoadjuvant approach in French expert centres. Tumour classification, location and patient age significantly influence treatment choices, reflecting a shift towards personalized context‐specific care. 10.1111/codi.70358 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/codi.70358 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_codi_70358 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Contemporary neoadjuvant strategies for rectal cancer: The GRECCAR snapshot study Antoine Cazelles Quentin Denost Benjamin Fernandez Michel Rivoire Hélène Meillat Philippe Rouanet Mehdi Karoui Adeline Germain Leon Maggiori Alain Valverde Nicolas Peru Eddy Cotte Etienne Buscail Jeremie H. Lefevre Bertrand Trilling Jean Luc Faucheron Pierre Yves Sage Laura Beyer‐Berjot Stephane Benoist Arnaud Alves Charles Sabbagh Jean‐Jacques Tuech Julien Coget Frédéric Marchal Guillaume Meurette Diane Mège Dahbia Djelil Simone Manfredelli Aurélien Venara Mehdi Ouaissi Gilles Manceau Colorectal Disease Contemporary neoadjuvant strategies for rectal cancer: The GRECCAR snapshot study Antoine Cazelles Quentin Denost Benjamin Fernandez Michel Rivoire Hélène Meillat Philippe Rouanet Mehdi Karoui Adeline Germain Leon Maggiori Alain Valverde Nicolas Peru Eddy Cotte Etienne Buscail Jeremie H. Lefevre Bertrand Trilling Jean Luc Faucheron Pierre Yves Sage Laura Beyer‐Berjot Stephane Benoist Arnaud Alves Charles Sabbagh Jean‐Jacques Tuech Julien Coget Frédéric Marchal Guillaume Meurette Diane Mège Dahbia Djelil Simone Manfredelli Aurélien Venara Mehdi Ouaissi Gilles Manceau Colorectal Disease Abstract Aim Neoadjuvant treatment for rectal cancer has evolved markedly with the growing adoption of total neoadjuvant therapy ( TNT ), organ‐preservation strategies and selective omission of radiotherapy. Recent trials support risk‐based personalization, but its application in real‐world settings remains poorly documented. The aim was to describe current neoadjuvant treatment practices for mid‐low rectal cancer in French expert centres and identify tumour‐ and patient‐related factors influencing decisions. Method This observational study included patients with non‐metastatic rectal adenocarcinoma ≤10 cm from the anal verge, discussed in tumour boards (October 2022 to March 2023) across GRECCAR centres. Tumours were classified as early, intermediate‐risk or locally advanced rectal cancer (LARC). Neoadjuvant treatments were analysed according to tumour extension, location and age. Results Among 463 patients from 27 centres, the most frequent regimen was induction chemotherapy, mainly FOLFIRINOX, followed by long‐course chemoradiotherapy (CRT) (65%). This approach was used in 51%, 66% and 71% of patients in the early, intermediate‐risk and LARC groups, respectively ( p = 0.0060). TNT was more frequently administered for low‐ than mid‐rectal cancers, especially in LARC (86% vs. 71%, p = 0.016). In patients >75 years, CRT + consolidation chemotherapy and radiotherapy alone were proportionally more frequent. Among the early rectal cancers, those treated with induction chemotherapy + CRT had more advanced features than those treated with CRT alone (cT3: 80% vs. 43%, cN+: 62% vs. 10%, tumour size: 3.4 vs. 2.3 cm; all p < 0.001). Conclusion TNT with induction chemotherapy is the predominant neoadjuvant approach in French expert centres. Tumour classification, location and patient age significantly influence treatment choices, reflecting a shift towards personalized context‐specific care. 10.1111/codi.70358 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Contemporary neoadjuvant strategies for rectal cancer: The GRECCAR snapshot study |
| topic | Colorectal Disease |
| url | https://onlinelibrary.wiley.com/doi/10.1111/codi.70358 |