Abstract
Rectal cancer commonly metastasizes to the liver, and treatment depends on the extent of liver and rectal disease. Systemic therapy can be used to facilitate resection of initially unresectable metastases as well as downsize a locally advanced rectal primary tumor. There are advantages to resecting the primary tumor and the metastasis simultaneously. However, if a threatened mesorectal margin remains after systemic therapy, liver surgery can be performed first, followed by chemoradiation and then rectal resection. If a complete clinical response is achieved in the primary tumor, a nonoperative approach can be considered in select cases.
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The authors gratefully acknowledge the editorial assistance of Arthur Gelmis.
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Langan, R.C., Weiser, M.R. (2020). Rectal Conditions: Stage IV Rectal Cancer. 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_40
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DOI: https://doi.org/10.1007/978-3-319-65942-8_40
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