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 Note
...recommendations (strong or conditional) repres...
Assessment
...ssessment
...1.Patients with locally advanced rectal can...
...nts with locally advanced rectal cancer should...
...se of a standardized synoptic MRI report is re...
Treatment
...eatment
...omes improved with combined neoadj...
...NT should be offered as initial treatment for pa...
...ts with locally advanced middle or upper rec...
...he context of TNT, should chemotherapy be deliver...
...r patients who are candidates for TNT, the re...
...e neoadjuvant setting, is short-co...
....1.If radiation is included in the treat...
...s nonoperative management recommended for patien...
...may be discussed as an alternative to TME for pa...
...-High (MSI-H) or mismatch repair de...
...rapy is recommended for tumors that are MSI-H or...
...re 1. Treatment of Locally Advanced Recta...