Abstract
The treatment algorithms for rectal cancer have become increasingly complex in the recent past. The detection, staging, treatment, and surveillance of rectal cancer require a multidisciplinary approach, expertise, and experience. Adjuvant and neoadjuvant therapies have important roles in optimizing locoregional control, recurrence rates, and survival after treatment of rectal cancer. Accurate tumor staging guides the use of these therapies. Neoadjuvant chemoradiotherapy has been repeatedly shown to be of benefit in appropriately selected patients, and recently there has been more research into the watch and wait approach for those patients who have a complete clinical response following neoadjuvant chemoradiotherapy. There are a number of issues surrounding the use of neoadjuvant and adjuvant therapy that remain controversial in the literature, including the sequencing of treatments for metastatic disease, the use of neoadjuvant therapy in patients with T3N0 disease and a clear circumferential resection margin, the timing of surgery following neoadjuvant chemoradiotherapy, and which patients will benefit from adjuvant chemotherapy if they have been downstaged following neoadjuvant chemoradiotherapy.
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Zwiep, T., Van Koughnett, J.A., Colquhoun, P.H.D. (2020). Rectal Conditions: Rectal Cancer—Adjuvant and Neoadjuvant Therapy. In: Steele, S., Maykel, J., Wexner, S. (eds) Clinical Decision Making in Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65942-8_39
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DOI: https://doi.org/10.1007/978-3-319-65942-8_39
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