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Local Failure After Conservative Treatment of Rectal Cancer

  • Salvatore PucciarelliEmail author
  • Andrea Barina
  • Antonio Rella
Part of the Updates in Surgery book series (UPDATESSURG)

Abstract

Rectal cancer (RC) management has changed dramatically over the last decade. Total mesorectal excision (TME) [1], performed with either an open or laparoscopic approach, is accepted worldwide as the standard surgical technique for cancer of the middle and lower rectum. Moreover, many randomized trials have clearly demonstrated that neoadjuvant therapy followed by surgery is superior to radical surgery alone and to postoperative chemoradiotherapy for locally advanced rectal cancer (TNM stage II–III) [2, 3]. With this approach, the 5-year local recurrence (LR) rates are reported to be <7%, and up to 20% of patients show pathological complete response (pCR). Patients with pCR show improved long-term outcomes compared with those with residual disease [4]. However, TME with preoperative chemoradiotherapy (PCRT) contributes to up to 6% of perioperative mortality [5], high rates of early and late complications, and bowel, urinary, and sexual dysfunction [6, 7]. Clinical TNM stage I RC is treated with TME alone, while locally advanced disease is usually treated with preoperative long-term radiotherapy concomitant with chemotherapy followed by TME.

Keywords

Overall Survival Local Recurrence Rectal Cancer Total Mesorectal Excision Local Excision 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  • Salvatore Pucciarelli
    • 1
    Email author
  • Andrea Barina
  • Antonio Rella
  1. 1.Department of Surgery, Oncology and GastroenterologyUniversity of PaduaPaduaItaly

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