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Rectal Cancer

  • Jinhui Zhu
  • Kai Yu
  • Ramon Andrade De MelloEmail author
Chapter

Abstract

Rectal cancer is a disease in which cancer cells form in the tissues of the rectum; colorectal cancer occurs in the colon or rectum. Adenocarcinomas comprise the vast majority (98%) of colon and rectal cancers; more rare rectal cancers include lymphoma (1.3%), carcinoid (0.4%), and sarcoma (0.3%).The incidence and epidemiology, etiology, pathogenesis, and screening recommendations are common to both colon cancer and rectal cancer.

The incidence of colorectal cancer rose dramatically following economic development and industrialization. The majority of colorectal cancers still occur in industrialized countries. Currently, the incidence of rectal cancer in the European Union is 15–25 cases/100 000 population per year and is predicted to increase further in both genders. High body mass index, body or abdominal fatness and diabetes type II are seen as risk factors. Longstanding ulcerative colitis and Crohn’s disease affecting the rectum, excessive consumption of red or processed meat and tobacco as well as moderate/heavy alcohol use increase the risk.

The usual pathogenesis of colorectal cancer is an adenomatous polyp that slowly increases in size, followed by dysplasia and finally cancer. Screening for colorectal cancer is valuable because early detection and removal of premalignant adenomas or localized cancer can prevent cancer or cancer-related deaths.

Although radical resection of rectum is the mainstay of therapy, surgery alone has a high recurrence rates. A multidisciplinary approach that includes colorectal surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer. Therefore, determination of optimal treatment plan for patients with rectal cancer involves a complex decision-making process.

Rectal cancer recurs in 5–30% of patients, usually in the first year after surgery. Tumor stage, grade, number of lymph node metastasis, lymphovascular involvement, signet cell appearance, achievement of negative radial margins, and distance from the radial margin are important prognostic indicators of local and distant recurrences.

Keywords

Rectal cancer Chemotherapy Radiotherapy 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of General Surgery, Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina
  2. 2.Division of Medical OncologyFederal University of São Paulo (UNIFESP) & Hospital Israelita Albert EinsteinSão PauloBrazil
  3. 3.Department of Biomedical Sciences and MedicineUniversity of AlgarveFaroPortugal

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