Locally Advanced Rectal Cancer
Key Points
Key Points
- Colon and rectal cancers are the fourth most common form of cancer in the United States (US). Rectal cancer accounts for approximately one-third of colorectal cancers.
- Chemoradiation (CRT) and chemotherapy (total neoadjuvant therapy [TNT]) should be offered as initial treatment for patients with tumors located in the lower rectum and/or patients who are at higher risk for local and/or distant metastases.
- Patients without these higher-risk factors may discuss chemotherapy with selective CRT depending on extent of response, TNT, or neoadjuvant long-course CRT or short-course radiation.
- Nonoperative management may be discussed as an alternative to total mesorectal excision (TME) for patients who have a clinical complete response to neoadjuvant therapy.
General Note
General Not...
...following recommendations (strong o...
Assessment
...essment...
...ts with locally advanced rectal cancer...
...ents with locally advanced rectal cancer sh...
...use of a standardized synoptic MRI re...
Treatment
...reatme...
...mproved with combined neoadjuvant chemotherapy...
...be offered as initial treatment for patients with...
...ith locally advanced middle or upper rectal cancer...
...of TNT, should chemotherapy be delivered before...
3.1For patients who are candidates for TNT...
...nt setting, is short-course radiati...
...radiation is included in the treatme...
...management recommended for patients who hav...
...y be discussed as an alternative to TME for patien...
...MSI-H) or mismatch repair deficient (dMM...
...Immunotherapy is recommended for tumors...
...1. Treatment of Locally Advanced Rectal Canc...