Rectal cancer management during the COVID-19 pandemic (ReCaP): multicentre prospective observational study.

Over 8000 patients are diagnosed with rectal cancer in the UK each year1. Treatment has improved over recent years as a result of incremental advances in optimized surgical technique, clinical staging, pathological quality control, and multidisciplinary management2. Neoadjuvant therapy is often required in patients with locally advanced tumours, and is usually delivered according to a long-course strategy (long-course radiotherapy, LCRT). Hypofractionated short-course strategies (short-course radiotherapy, SCRT) may also be used, traditionally with immediate surgery, but recently have been combined with strategies such as delayed surgery3,4 and/or systemic chemotherapy5. Such regimens offer potential benefits for patients in terms of reducing treatment time and access to systemic therapy, but may also be of use in areas with limited healthcare resources or geographical access to specialist services5,6. The COVID-19 pandemic has created a unique situation in the UK, with multidisciplinary teams balancing the risks of perioperative COVID infection against those of disease progression. Coupled with altered patient behaviour in accessing healthcare, constrained diagnostic and critical care facilities, there has been rapid change in the traditional multimodal treatment strategy for rectal cancer7. The aim of the prospective ReCaP study was to follow patients with rectal cancer managed in the UK during the pandemic, and to determine short-term, long-term, and patient-reported outcomes. This article presents the short-term results for the first 500 patients recruited.