Published online Aug 27, 2019. doi: 10.4240/wjgs.v11.i8.334
Peer-review started: June 4, 2019
First decision: August 2, 2019
Revised: August 10, 2019
Accepted: August 13, 2019
Article in press: August 2, 2019
Published online: August 27, 2019
Core tip: The current mainstay treatment of anorectal leiomyosarcoma is surgical resection with negative margins. Based on the published case series and reports, sphincter-preserving surgery followed by radiotherapy yields local recurrence rates that are comparable to radical resection. Moreover, neoadjuvant radiation improves local recurrence rates, as compared to adjuvant radiation. Adjuvant chemotherapy significantly improves rates of distant recurrence and overall survival; however, the choice to use chemotherapy in this setting should be determined according to a multidisciplinary team consideration of patient-related factors and treatment toxicity. Since local and distant tumor recurrences are common, even years after resection, post-surgery long-term follow-up is needed.