Abstract

The management of rectal cancer has transformed over the last 3 decades and continues to evolve. Some of these changes parallel progress made with other cancers: refinement of surgical technique to improve organ preservation, selective use of neoadjuvant (and adjuvant) therapy, and emergence of criteria suggesting a role for individually tailored therapy. Other changes are driven by fairly unique issues including functional considerations, rectal anatomic features, and surgical technical issues. Further complexity is due to the variety of staging modalities (each with its own limitations), neoadjuvant treatment alternatives, and competing strategies for sequencing multimodal treatment even for nonmetastatic disease. Importantly, observations of tumor response made in the era of neoadjuvant therapy are reshaping some traditionally held concepts about tumor behavior. Frameworks for prioritizing and integrating complex data can help to formulate treatment plans for patients.

Links

Publisher Full Text

Authors

Kosinski L, Habr-Gama A, Ludwig K, Perez R

Institution

Division of Colorectal Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA. lkosinski@mcw.edu

Source

CA: a cancer journal for clinicians 62:3 pg 173-202

MeSH

Biopsy
Combined Modality Therapy
Diagnostic Imaging
Early Diagnosis
Humans
Neoplasm Staging
Outcome Assessment (Health Care)
Patient Care Team
Practice Guidelines as Topic
Rectal Neoplasms

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22488575