Indications for Systemic Chemotherapy
Local recurrence (LR) after curative surgery is a critical problem for patients with colorectal cancer (CRC). Over the last two decades, oncologic treatment results for primary rectal cancer have improved due to refinements in neoadjuvant chemotherapy, radiation, and surgery. Nevertheless, there is still a 5–10% rate of LR, threatening the survival and quality of life of affected patients . LR is best defined as any tumor recurring within the true pelvis, including neorectum, mesentery, pelvic viscera, pelvic sidewall structures, and bone. Due to variability of anatomy and clinical presentation, detection, staging, and clinical management are complex. About half of all LRs are limited to the pelvis and can be considered for curative re-excision  (Table 6.1).
KeywordsOverall Survival Rectal Cancer Total Mesorectal Excision Overall Response Rate Optimal Treatment Strategy
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