A study looking at radiotherapy and surgery to treat cancer of the back passage (TREC)
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This study compared surgery to remove the whole back passage (rectum), to radiotherapy followed by surgery to remove the part of the rectum.
The study was supported by Cancer Research UK. It was open for people to join between 2012 and 2014, and the team published the results in 2021. There is a link to more information in the ‘Summary of results’ section below.
More about this trial
When this study was done, doctors usually treated bowel (rectal) cancer with surgery to remove the whole rectum, even if it was early 
cancer. But it is a big operation. Some people have serious side effects which affect their quality of life.
Researchers wanted to see if it was useful to have radiotherapy to shrink the cancer first. And then have a smaller keyhole (laparoscopic) operation to remove just the area of cancer. They hoped it would work as well as the bigger operation and cause fewer side effects.
Everyone in this study had early stage rectal cancer that had not spread to or any other part of the body.
Some people had major surgery to remove all of their rectum. Others had a course of radiotherapy first and then a smaller operation. Doctors call this organ preserving surgery, because they remove less of the rectum.
The main aims of this pilot study were to see:
- how well radiotherapy followed by keyhole surgery works for early stage rectal cancer
- how many people go on and have a larger operation to remove their rectum
- how the two treatments affected people’s quality of life
- whether it’s possible to run a larger trial comparing these treatments
Summary of results
We aim to add a lay summary of results to all the studies on our database. Unfortunately we have not been able to include a summary for this one.
There is more information about the results in the link below.
Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.
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
Simon P Bach and others
The Lancet, 2021. Volume 6, issue 2, pages 92-105.
Recruitment start:
Recruitment end:
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Chief Investigator
Professor Simon Bach
Supported by
Cancer Research UK
NIHR Clinical Research Network: Cancer
National Cancer Research Institute Colorectal Cancer Clinical Studies Group
University of Birmingham
Other information
This is Cancer Research UK trial number CRUK/09/032.
The team went on to run a larger trial looking at this, and we have information on our database about the STAR-TREC trial.
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040
