Published online Jan 28, 2014. doi: 10.3748/wjg.v20.i4.877
Revised: November 22, 2013
Accepted: January 6, 2014
Published online: January 28, 2014
Processing time: 121 Days and 17 Hours
Management of rectal cancer has markedly evolved over the last two decades. New technologies of staging have allowed a more precise definition of tumor extension. Refinements in surgical concepts and techniques have resulted in higher rates of sphincter preservation and better functional outcome for patients with this malignancy. Although, preoperative chemoradiotherapy followed by total mesorectal excision has become the standard of care for locally advanced tumors, many controversial matters in management of rectal cancer still need to be defined. These include the feasibility of a non-surgical approach after a favorable response to neoadjuvant therapy, the ideal margins of surgical resection for sphincter preservation and the adequacy of minimally invasive techniques of tumor resection. In this article, after an extensive search in PubMed and Embase databases, we critically review the current strategies and the most debatable matters in treatment of rectal cancer.
Core tip: Rectal cancer management is currently a multidisciplinary effort, which incorporates new concepts and technologies, resulting in significant improvement in patients’ oncological and functional outcomes. Despite the evolution reported in the last decades, there are still many unanswered questions about treatment of rectal cancer. In this article, we critically analyzed the main controversial matters in current rectal cancer management.