Open AccessLocally advanced rectal cancer: The importance of a multidisciplinary approach
Author(s) -
Rossana Berardi,
Elena Maccaroni,
Azzurra Onofri,
Francesca Morgese,
Mariangela Torniai,
Michela Tiberi,
Consuelo Ferrini,
Stefano Cascinu
Publication year - 2014
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v20.i46.17279
Subject(s) - medicine , total mesorectal excision , colorectal cancer , chemoradiotherapy , neoadjuvant therapy , surgery , radiation therapy , cancer , radical surgery , multidisciplinary approach , oncology , social science , sociology , breast cancer
Rectal cancer accounts for a relevant part of colorectal cancer cases, with a mortality of 4-10/1 per year. The development of locoregional recurrences and the occurrence of distant metastases both influences the prognosis of these patients. In the last two decades, new multimodality strategies have improved the prognosis of locally advanced rectal cancer with a significant reduction of local relapse and an increase in terms of overall survival. Radical surgery still remains the principal curative treatment and the introduction of total mesorectal excision has significantly achieved a reduction in terms of local recurrence rates. The employment of neoadjuvant treatment, delivered before surgery, also achieved an improved local control and an increased sphincter preservation rate in low-lying tumors, with an acceptable acute and late toxicity. This review describes the multidisciplinary management of rectal cancer, focusing on the effectiveness of neoadjuvant chemoradiotherapy and of post-operative adjuvant chemotherapy both in the standard combined modality treatment programs and in the ongoing research to improve these regimens.