TY - CHAP M1 - Book, Section TI - Multimodality Treatment of Rectal Cancer 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. PY - 2018 T2 - Textbook of Complex General Surgical Oncology 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. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - hemonc.mhmedical.com/content.aspx?aid=1145762581 ER -