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Local Failure After Conservative Treatment of Rectal Cancer

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Multimodal Treatment of Recurrent Pelvic Colorectal Cancer

Part of the book series: Updates in Surgery ((UPDATESSURG))

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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.

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Authors and Affiliations

  1. Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy

    Salvatore Pucciarelli

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  1. Salvatore Pucciarelli
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  2. Andrea Barina
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  3. Antonio Rella
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Correspondence to Salvatore Pucciarelli .

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Editors and Affiliations

  1. Gastrointestinal Surgical Oncology Department of Abdominal Oncology, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy

    Giovanni Maria Romano

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Pucciarelli, S., Barina, A., Rella, A. (2016). Local Failure After Conservative Treatment of Rectal Cancer. In: Romano, G.M. (eds) Multimodal Treatment of Recurrent Pelvic Colorectal Cancer. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5767-8_14

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  • DOI: https://doi.org/10.1007/978-88-470-5767-8_14

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5766-1

  • Online ISBN: 978-88-470-5767-8

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