Updating the Management of Rectal Cancer
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Viorica Magdalena Nagy
Radiotherapy Department , "Ion Chiricuta" Oncology
Institute, University of Medicine and Pharmacy "Iuliu Hatieganu"
Cluj-Napoca, Romania
Abstract
In the last 25 years rectal cancer has changed from a surgically
managed disease into a multidisciplinary treatment model. Accurate
staging has a critical role in the decision-making process of
patients with rectal cancer. The four most commonly used imaging
modalities in the pretherapeutical staging include endoscopic
ultrasound, computerized tomography, magnetic resonance imaging
and positron emission tomography.
Locoregional tumor control in rectal cancer surgery has improved
significantly over the last 15 years, after the introduction of
total mesorectal excision (TME), which leads to the complete removal
of the intact mesorectum including the lymphatics, lymph nodes,
nerves, and vascular supply.
At the present time, given the improved local control, acute and
long-term toxicity profile, and sphincter preservation rate, patients
who require combined modality therapy should receive concomitant
radiochemotherapy preoperatively. Recently, the novel ‘targeted’
therapies have been incorporated into a multidisciplinary approach
for rectal cancer.
Key words
Rectal cancer - surgery - radiochemotherapy
