Multimodality management of locally advanced rectal cancer.

Journal Article (Journal Article;Review)

Despite the routine use of adjuvant chemoradiation for curatively resected stage II and III rectal cancer a significant percentage of patients ultimately fail locally and/or distally; this underscores the need for continued improvement in the efficacy of combined-modality therapy and quality of rectal cancer resection. The recognition of the significance of lateral or circumferential margins of resection has paralleled the widespread use of total mesorectal excision. In addition to facilitating negative margins of resection and local control, sharp mesorectal techniques also facilitate identification and preservation of pelvic autonomic nerves thereby greatly reducing the incidence of urinary and sexual dysfunction following radical resection. Lastly, restorative options can result in excellent bowel function in carefully selected patients undergoing a "very low" anterior resection. Efforts are currently directed at identifying the subset of locally advanced rectal cancer patients who may be adequately treated with a resection alone thereby avoiding the added morbidity of adjuvant radiation and chemotherapy.

Full Text

Duke Authors

Cited Authors

  • Moore, HG; Guillem, JG

Published Date

  • July 2003

Published In

Volume / Issue

  • 69 / 7

Start / End Page

  • 612 - 619

PubMed ID

  • 12889627

International Standard Serial Number (ISSN)

  • 0003-1348


  • eng

Conference Location

  • United States