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February-2026 Volume 31 Issue 2

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Case Report

Curative surgery enabled by radiotherapy in rectal cancer: A case report

  • Authors:
    • Sofia E. Sánchez‑De‑Toca Gómez
    • Fernando Mendoza Moreno
    • Patricia Urbón Sánchez
    • Felix Mañes Jiménez
    • Yousef Allaoua Massaoui
    • Lucas Casalduero García
    • Pablo Barat Betrán
    • Alejandra Julia Lopez Marsellá
    • María Mejías Ledesma
    • Alberto Vilar Tabanera
    • Manuel Diez Alonso
    • Alberto Gutiérrez Calvo
  • View Affiliations / Copyright

    Affiliations: Department of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, 28805 Madrid, Spain
  • Article Number: 92
    |
    Published online on: December 31, 2025
       https://doi.org/10.3892/ol.2025.15445
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Abstract

Neoadjuvant chemo‑radiotherapy is the standard of care for patients with locally advanced rectal cancer. However, certain patients are ineligible for chemotherapy due to clinical contraindications such as active infections. Although neoadjuvant therapy remains the preferred approach, guidelines are limited for patients who cannot receive combined treatment. The present report describes a case in which radiotherapy alone, initiated with palliative intent, enabled complete surgical resection. A 46‑year‑old male patient presented with fever and proctalgia. Imaging revealed a large rectal mass associated with an ischiorectal abscess. Biopsy confirmed T4bN1 rectal adenocarcinoma. Chemotherapy was contraindicated due to ongoing infection; therefore, a diverting colostomy was performed. Short‑course radiotherapy led to marked tumor regression. Subsequent pelvic exenteration achieved complete tumor removal. Postoperative wound dehiscence was managed successfully with vacuum‑assisted closure therapy. No recurrence was observed on follow‑up. The current case illustrates that radiotherapy alone may serve as a bridge to curative surgery in patients unfit for chemo‑radiotherapy. The use of 3D reconstruction markedly improved preoperative planning and facilitated precise surgical resection. Additionally, perineal closure with Vicryl mesh and omental interposition minimized postoperative complications. In conclusion, in selected patients with contraindications to total neoadjuvant therapy, radiotherapy alone may be a feasible alternative to enable radical resection. Advanced surgical planning with 3D modeling can enhance outcomes in complex pelvic surgery.
View Figures

Figure 1

Findings of the first surgical
procedure: Tumoral mass presentation as a perineal abscess.

Figure 2

(A) CT scan and (B) MRI findings
before radiotherapy treatment (the arrow indicates the tumoral
mass).

Figure 3

(A) CT scan and (B) MRI findings after
radiotherapy treatment (the arrow indicates the tumoral mass).

Figure 4

3D models generated using Cella
Medical solutions®. (A) General overview and structures.
(B) Tumoral relationship with adjacent structures (yellow item).
The label indicates the anatomical location of the colon and
rectum.

Figure 5

Perineal closure. (A) Epiplon covering
the intestinal loops. (B) Closure vicryl mesh. (C) Final closure.
(D) Surgical specimen.

Figure 6

Perineal closure evolution. (A)
Initial dehiscence. (B) Vacuum-assisted closure therapy. (C)
Result.
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Copy and paste a formatted citation
Spandidos Publications style
Sánchez‑De‑Toca Gómez SE, Moreno FM, Sánchez PU, Jiménez FM, Massaoui YA, García LC, Betrán PB, Lopez Marsellá AJ, Ledesma MM, Tabanera AV, Tabanera AV, et al: Curative surgery enabled by radiotherapy in rectal cancer: A case report. Oncol Lett 31: 92, 2026.
APA
Sánchez‑De‑Toca Gómez, S.E., Moreno, F.M., Sánchez, P.U., Jiménez, F.M., Massaoui, Y.A., García, L.C. ... Calvo, A.G. (2026). Curative surgery enabled by radiotherapy in rectal cancer: A case report. Oncology Letters, 31, 92. https://doi.org/10.3892/ol.2025.15445
MLA
Sánchez‑De‑Toca Gómez, S. E., Moreno, F. M., Sánchez, P. U., Jiménez, F. M., Massaoui, Y. A., García, L. C., Betrán, P. B., Lopez Marsellá, A. J., Ledesma, M. M., Tabanera, A. V., Alonso, M. D., Calvo, A. G."Curative surgery enabled by radiotherapy in rectal cancer: A case report". Oncology Letters 31.2 (2026): 92.
Chicago
Sánchez‑De‑Toca Gómez, S. E., Moreno, F. M., Sánchez, P. U., Jiménez, F. M., Massaoui, Y. A., García, L. C., Betrán, P. B., Lopez Marsellá, A. J., Ledesma, M. M., Tabanera, A. V., Alonso, M. D., Calvo, A. G."Curative surgery enabled by radiotherapy in rectal cancer: A case report". Oncology Letters 31, no. 2 (2026): 92. https://doi.org/10.3892/ol.2025.15445
Copy and paste a formatted citation
x
Spandidos Publications style
Sánchez‑De‑Toca Gómez SE, Moreno FM, Sánchez PU, Jiménez FM, Massaoui YA, García LC, Betrán PB, Lopez Marsellá AJ, Ledesma MM, Tabanera AV, Tabanera AV, et al: Curative surgery enabled by radiotherapy in rectal cancer: A case report. Oncol Lett 31: 92, 2026.
APA
Sánchez‑De‑Toca Gómez, S.E., Moreno, F.M., Sánchez, P.U., Jiménez, F.M., Massaoui, Y.A., García, L.C. ... Calvo, A.G. (2026). Curative surgery enabled by radiotherapy in rectal cancer: A case report. Oncology Letters, 31, 92. https://doi.org/10.3892/ol.2025.15445
MLA
Sánchez‑De‑Toca Gómez, S. E., Moreno, F. M., Sánchez, P. U., Jiménez, F. M., Massaoui, Y. A., García, L. C., Betrán, P. B., Lopez Marsellá, A. J., Ledesma, M. M., Tabanera, A. V., Alonso, M. D., Calvo, A. G."Curative surgery enabled by radiotherapy in rectal cancer: A case report". Oncology Letters 31.2 (2026): 92.
Chicago
Sánchez‑De‑Toca Gómez, S. E., Moreno, F. M., Sánchez, P. U., Jiménez, F. M., Massaoui, Y. A., García, L. C., Betrán, P. B., Lopez Marsellá, A. J., Ledesma, M. M., Tabanera, A. V., Alonso, M. D., Calvo, A. G."Curative surgery enabled by radiotherapy in rectal cancer: A case report". Oncology Letters 31, no. 2 (2026): 92. https://doi.org/10.3892/ol.2025.15445
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