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Chemoradiation for Rectal Cancer

  • Keiji Koda
Chapter

Abstract

Chemoradiation therapy (CRT) is a component of various rectal cancer treatments. Preoperative CRT is administered in combination with local excision when the depth of invasion is limited to the muscle layer (cT2). It is also administered in combination with total mesorectal excision (TME) when the tumor is of higher T stage or N-positive and curative resection is anticipated. In Japan, lateral pelvic lymph node dissection (LLND) is often performed without preoperative CRT when a rectal cancer of T3 stage or greater depth of invasion is located below the peritoneal reflection. When there is a risk of a positive circumferential margin or the tumor is T4, preoperative CRT is performed with the aim of making the resection curative. Total pelvic exenteration is often performed in Japan when massive tumor invasion of the genitourinary organs is suspected. The “watch-and-wait” strategy when clinical CR has been achieved is to be evaluated further.

Keywords

Chemoradiation therapy Rectal cancer Chemotherapy Local excision Total mesorectal excision Lateral pelvic lymph node dissection Watch-and-wait 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of SurgeryTeikyo University Chiba Medical CenterIchiharaJapan

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