Current topics in the multimodality treatment of locally advanced rectal cancer

2016 ◽  
Vol 12 (7) ◽  
pp. 963-979 ◽  
Author(s):  
Suzanne Russo ◽  
Scott Steele ◽  
Elisha Fredman ◽  
Tithi Biswas
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Multimodality Treatment ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer

Patterns of local recurrence in locally advanced rectal cancer after intra-operative radiotherapy containing multimodality treatment

2009 ◽  
Vol 92 (2) ◽  
pp. 221-225 ◽  
Author(s):  
Miranda Kusters ◽  
Fabian A. Holman ◽  
Hendrik Martijn ◽  
Grard A. Nieuwenhuijzen ◽  
Geert-Jan Creemers ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Locally Advanced ◽  
Multimodality Treatment ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer

scholarly journals Advances and Challenges in Treatment of Locally Advanced Rectal Cancer

2015 ◽  
Vol 33 (16) ◽  
pp. 1797-1808 ◽  
Author(s):  
J. Joshua Smith ◽  
Julio Garcia-Aguilar
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Surgical Techniques ◽  
Multimodality Treatment ◽  
Complete Response ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Treatment Regimens ◽  
Treatment Paradigm

Dramatic improvements in the outcomes of patients with rectal cancer have occurred over the past 30 years. Advances in surgical pathology, refinements in surgical techniques and instrumentation, new imaging modalities, and the widespread use of neoadjuvant therapy have all contributed to these improvements. Several questions emerge as we learn of the benefits or lack thereof for components of the current multimodality treatment in subgroups of patients with nonmetastatic locally advanced rectal cancer (LARC). What is the optimal surgical technique for distal rectal cancers? Do all patients need postoperative chemotherapy? Do all patients need radiation? Do all patients need surgery, or is a nonoperative, organ-preserving approach warranted in selected patients? Answering these questions will lead to more precise treatment regimens, based on patient and tumor characteristics, that will improve outcomes while preserving quality of life. However, the idea of shifting the treatment paradigm (chemoradiotherapy, total mesorectal excision, and adjuvant therapy) currently applied to all patients with LARC to a more individually tailored approach is controversial. The paradigm shift toward organ preservation in highly selected patients whose tumors demonstrate clinical complete response to neoadjuvant treatment is also controversial. Herein, we highlight many of the advances and resultant controversies that are likely to dominate the research agenda for LARC in the modern era.

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