{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:46:31Z","timestamp":1787579191020,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","award":["KUN 2020\u201013046"],"award-info":[{"award-number":["KUN 2020\u201013046"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["CRUK\/19\/005"],"award-info":[{"award-number":["CRUK\/19\/005"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Organ\u2010saving treatment for early\u2010stage rectal cancer can reduce patient\u2010reported side effects compared to standard total mesorectal excision (TME) and preserve quality of life. An optimal strategy for achieving organ preservation and longer\u2010term oncological outcomes are unknown; thus there is a need for high quality trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Can we\n                      <jats:styled-content>S<\/jats:styled-content>\n                      ave the rectum by watchful waiting or\n                      <jats:styled-content>T<\/jats:styled-content>\n                      rans\n                      <jats:styled-content>A<\/jats:styled-content>\n                      nal surgery following (chemo)\n                      <jats:styled-content>R<\/jats:styled-content>\n                      adiotherapy versus\n                      <jats:styled-content>T<\/jats:styled-content>\n                      otal mesorectal excision for early\n                      <jats:styled-content>RE<\/jats:styled-content>\n                      ctal\n                      <jats:styled-content>C<\/jats:styled-content>\n                      ancer (STAR\u2010TREC) is an international three\u2010arm multicentre, partially randomized controlled trial incorporating an external pilot. In phase III, patients with cT1\u20103b N0 tumours, \u226440\u00a0mm in diameter, who prefer organ preservation are randomized 1:1 between mesorectal long\u2010course chemoradiation versus mesorectal short\u2010course radiotherapy, with selective transanal microsurgery. Patients preferring radical surgery receive TME. STAR\u2010TREC aims to recruit 380 patients to organ preservation and 120 to TME surgery. The primary outcome is the rate of organ preservation at 30\u00a0months. Secondary clinician\u2010reported outcomes include acute treatment\u2010related toxicity, rate of non\u2010operative management, non\u2010regrowth pelvic tumour control at 36\u00a0months, non\u2010regrowth disease\u2010free survival at 36\u00a0months and overall survival at 60\u00a0months, and patient\u2010reported toxicity, health\u2010related quality of life at baseline, 12 and 24\u00a0months. Exploratory biomarker research uses circulating tumour DNA to predict response and relapse.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>STAR\u2010TREC will prospectively evaluate contrasting therapeutic strategies and implement new measures including a smaller mesorectal target volume, two\u2010step response assessment and non\u2010operative management for complete response. The trial will yield important information to guide routine management of patients with early\u2010stage rectal cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.16056","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T12:04:56Z","timestamp":1643889896000},"page":"639-651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Can we Save the rectum by watchful waiting or TransAnal surgery following (chemo)Radiotherapy versus Total mesorectal excision for early REctal Cancer (STAR\u2010TREC)? Protocol for the international, multicentre, rolling phase II\/III partially randomized patient preference trial evaluating long\u2010course concurrent chemoradiotherapy versus short\u2010course radiotherapy organ preservation approaches"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8412-7241","authenticated-orcid":false,"given":"Simon P.","family":"Bach","sequence":"first","affiliation":[{"name":"D3B [Drugs, Devices, Diagnostics and Biomarkers] Cancer Research UK Clinical Trials Unit  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the STAR\u2010TREC Collaborative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Global Cancer Observatory: Cancer Today","author":"Ferlay J","year":"2020"},{"key":"e_1_2_10_3_1","unstructured":"BoyleJ BraunM HillJ KurybaA vanMeulenJ&WalkerKet al. National bowel cancer audit: annual report; 2018.https:\/\/www.nboca.org.uk\/content\/uploads\/2018\/12\/NBOCA\u2010annual\u2010report2018.pdf(Accessed 10 March 2021)."},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13705"},{"key":"e_1_2_10_5_1","unstructured":"NICEColorectal cancer NG151. 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