What we learn from randomized trials in rectal cancer and what we can trust

Results of the management of rectal cancer have enormously improved over the last almost forty years, by the progressive development of new integrated treatment options. nevertheless an optimization of the results is needed to raise the still sub-optimal outcome in terms of survival. several national and international guidelines address the best treatment choice overall evaluating the evidence basis available from literature. Still a certain degree of disagreement is present, particularly about the preferable preoperative rt treatment schedule. randomized trials represent the main landmark and most important tool for the scientific scenario: defining a potentially established standard of care, or suggesting the more promising approach to focus the re- search into, thus orienting the efforts of clinicians and researchers. This manuscript will mainly focus on the evidences derived from randomized clinical trial describing the main issues about the multimodal integrated treatment for rectal cancers. It will focus on both locally advanced (LA)/primary unresectable (UR), and resectable rectal cancers; some non-randomized trials of relevant the dissertation will also be mentioned.