Locally Advanced Rectal Cancer
Publication Date: August 8, 2024
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
...eneral N...
...owing recommendations (strong or con...
Assessment
...sessmen...
....1.Patients with locally advanced rectal...
...with locally advanced rectal cancer...
....The use of a standardized synopti...
Treatment
Treatmen...
...improved with combined neoadjuvan...
...NT should be offered as initial trea...
...ith locally advanced middle or uppe...
...context of TNT, should chemotherapy be delivered...
...atients who are candidates for TNT, the recomme...
...neoadjuvant setting, is short-cour...
...diation is included in the treatment pla...
...operative management recommended fo...
...ay be discussed as an alternative to...
...igh (MSI-H) or mismatch repair def...
...py is recommended for tumors that are MSI...
...e 1. Treatment of Locally Advanced R...