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
...eral Not...
...following recommendations (strong o...
Assessment
...ssessmen...
...ents with locally advanced rectal cance...
...nts with locally advanced rectal cancer...
...a standardized synoptic MRI report is re...
Treatment
Treatme...
...comes improved with combined neoadjuv...
...ld be offered as initial treatment for patients wi...
...Patients with locally advanced middle or upper...
...context of TNT, should chemotherapy be delivere...
...patients who are candidates for TNT, the recomm...
...the neoadjuvant setting, is short-course rad...
...iation is included in the treatment...
...operative management recommended for patients who...
....1.NOM may be discussed as an alternative to TME...
...MSI-High (MSI-H) or mismatch repair defi...
...y is recommended for tumors that are MS...
...e 1. Treatment of Locally Advanced Rectal Cancer...