Abstract

Treatment for rectal cancer continues to develop towards the improved local control and overall survival, maintaining quality of life, and preserving sphincter, genitourinary, and sexual function. Preoperative assessment for tumor depth, lymph node, and distant metastasis has an important role on treatment plan. Preoperative staging is used to determine the indication for neoadjuvant therapy as well as the indication for local excision versus radical cancer resection. Local excision is likely to be curative in patients whose tumor are confined to the submucosa without regional lymph and systemic metastasis. Total mesorectal excision (TME) and autonomic nerve preservation are standard procedure for advanced rectal cancer. In patients with advanced tumor stage (T3/T4 and/or N1) with no distant metastasis, preoperative chemoradiation followed by radical resection has become widely accepted recently.

• Keywords: Rectal cancer, Local excision, Total mesorectal excision, Preoperative chemoradiation