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Surg Clin North Am. 2009 Feb;89(1):177-215, ix-x. doi: 10.1016/j.suc.2008.09.021.

The multidisciplinary management of rectal cancer.

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  • 1Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.


Advancements have been made in multiple aspects of diagnostic and therapeutic approaches to rectal cancer. These advances include clinical staging such as endorectal ultrasound and pelvic MRI, surgical approaches such as transanal excision, and adjuvant treatments such as new chemotherapeutic agents and refined radiotherapy techniques. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with treatment decisions based on precise patient evaluations by a group of clinicians, including surgeons, gastroenterologists, medical and radiation oncologists, radiologists, and pathologists. The accurate identification of patients who are candidates for combined modality treatment is particularly essential to optimize outcomes. Technical and technologic advances have led to the availability of a wide range of surgical approaches for managing rectal cancer. Concomitantly, similar critical developments and refinements have also occurred in the administration of radiation and chemotherapeutic agents. This article provides an overview of the multimodal treatment of patients who have rectal cancer, with a focus on staging, surgical techniques, and the application of chemotherapy or radiation in the adjuvant and neoadjuvant settings.

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