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@article{Bach:2021:10.1016/S2468-1253(20)30333-2,
author = {Bach, SP and Gilbert, A and Brock, K and Korsgen, S and Geh, I and Hill, J and Gill, T and Hainsworth, P and Tutton, MG and Khan, J and Robinson, J and Steward, M and Cunningham, C and Levy, B and Beveridge, A and Handley, K and Kaur, M and Marchevsky, N and Magill, L and Russell, A and Quirke, P and West, NP and Sebag-Montefiore, D and TREC, collaborators},
doi = {10.1016/S2468-1253(20)30333-2},
journal = {The Lancet Gastroenterology and Hepatology},
pages = {92--105},
title = {Radical surgery versus organ preservation via short-course radiotherapy followed by transanal endoscopic microsurgery for early-stage rectal cancer (TREC): a randomised, open-label feasibility study.},
url = {http://dx.doi.org/10.1016/S2468-1253(20)30333-2},
volume = {6},
year = {2021}
}

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TY  - JOUR
AB  - BACKGROUND: Radical surgery via total mesorectal excision might not be the optimal first-line treatment for early-stage rectal cancer. An organ-preserving strategy with selective total mesorectal excision could reduce the adverse effects of treatment without substantially compromising oncological outcomes. We investigated the feasibility of recruiting patients to a randomised trial comparing an organ-preserving strategy with total mesorectal excision. METHODS: TREC was a randomised, open-label feasibility study done at 21 tertiary referral centres in the UK. Eligible participants were aged 18 years or older with rectal adenocarcinoma, staged T2 or lower, with a maximum diameter of 30 mm or less; patients with lymph node involvement or metastases were excluded. Patients were randomly allocated (1:1) by use of a computer-based randomisation service to undergo organ preservation with short-course radiotherapy followed by transanal endoscopic microsurgery after 8-10 weeks, or total mesorectal excision. Where the transanal endoscopic microsurgery specimen showed histopathological features associated with an increased risk of local recurrence, patients were considered for planned early conversion to total mesorectal excision. A non-randomised prospective registry captured patients for whom randomisation was considered inappropriate, because of a strong clinical indication for one treatment group. The primary endpoint was cumulative randomisation at 12, 18, and 24 months. Secondary outcomes evaluated safety, efficacy, and health-related quality of life assessed with the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and CR29 in the intention-to-treat population. This trial is registered with the ISRCTN Registry, ISRCTN14422743. FINDINGS: Between Feb 22, 2012, and Dec 19, 2014, 55 patients were randomly assigned at 15 sites; 27 to organ preservation and 28 to radical surgery. Cumulatively, 18 patients had been randomly assigned at 12 months, 31 a
AU  - Bach,SP
AU  - Gilbert,A
AU  - Brock,K
AU  - Korsgen,S
AU  - Geh,I
AU  - Hill,J
AU  - Gill,T
AU  - Hainsworth,P
AU  - Tutton,MG
AU  - Khan,J
AU  - Robinson,J
AU  - Steward,M
AU  - Cunningham,C
AU  - Levy,B
AU  - Beveridge,A
AU  - Handley,K
AU  - Kaur,M
AU  - Marchevsky,N
AU  - Magill,L
AU  - Russell,A
AU  - Quirke,P
AU  - West,NP
AU  - Sebag-Montefiore,D
AU  - TREC,collaborators
DO  - 10.1016/S2468-1253(20)30333-2
EP  - 105
PY  - 2021///
SN  - 2468-1253
SP  - 92
TI  - Radical surgery versus organ preservation via short-course radiotherapy followed by transanal endoscopic microsurgery for early-stage rectal cancer (TREC): a randomised, open-label feasibility study.
T2  - The Lancet Gastroenterology and Hepatology
UR  - http://dx.doi.org/10.1016/S2468-1253(20)30333-2
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33308452
UR  - https://www.sciencedirect.com/science/article/pii/S2468125320303332?via%3Dihub
UR  - http://hdl.handle.net/10044/1/85794
VL  - 6
ER  -

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