RT Book, Section
A1 Kwaan, Mary R.
A1 Lee, Janet T.
A1 Madoff, Robert D.
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145762581
T1 Multimodality Treatment of Rectal Cancer
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK hemonc.mhmedical.com/content.aspx?aid=1145762581
RD 2024/04/19
AB Rectal  and  colon  adenocarcinoma  originate  from  the  same  epithelial  cell  types  and  share  the  same  histologic  features.  Unlike  the  colon,  the  rectum  lacks  a  peritoneal  lining,  and  the  tight  confines  of  the  pelvis  pose  a  challenge  to  surgical  resection  with  clear  margins.  These  features  may  explain  the  higher  local  recurrence  rates  seen  in  rectal  cancer  compared  with  colon  cancer.  Prior  to  the  advent  of  multimodality  treatment  of  rectal  cancer,  local  recurrence  rates  of  5%  to  10%  for  stage  I,  25%  to  30%  for  stage  II,  and  >50%  for  stage  III  tumors  were  reported.1  Pelvic  radiation  therapy  offers  a  protective  effect  against  local  recurrence,  and  over  the  past  decades  preoperative  (neoadjuvant)  timing  has  prevailed.  The  effects  of  radiation  on  tumor  eradication  can  be  potentiated  with  concurrent  chemotherapy,  particularly  with  fluorouracil-based  chemotherapy.  However,  surgical  management  with  a  total  mesorectal  excision  (TME)  remains  as  the  key  feature  of  modern  rectal  cancer  care.