title: Recommendations and expert opinion on the treatment of locally advanced rectal cancer in Spain.
abstract: In Spain 22,000 new cases of colorectal cancer are diagnosed each year, with 13,075 deaths resulting from this disease. Around 70% of colorectal cancers are localised in the colon and 30% in the rectum. A group of Spanish experts established recommendations on what would be the best strategy in the treatment of locally advanced rectal cancer (LARC). Adequate assessment of local tumour extension, including high-resolution magnetic resonance imaging and endorectal ultrasound, is essential for successful treatment. The three cornerstones in the treatment of LARC are surgery, radiotherapy and chemotherapy. Most patients will need a total mesorectal excision (TME). Preoperative chemo-radiotherapy (CRT) is preferred for the majority of patients with T3/T4 disease and/or regional node involvement, and adjuvant chemotherapy is recommended after a patient-sharing decision. Capecitabine, after showing a trend in improved downstaging in neoadjuvant stratum and the convenience of its oral administration, represents an alternative to 5-FU as perioperative treatment of LARC.
authors: Hospital 12 de Octubre, Madrid, Spain.
authors: C
authors: C
authors: Grávalos
authors: P
authors: P
authors: García-Alfonso
authors: R
authors: R
authors: Afonso
authors: V
authors: V
authors: Arrazubi
authors: A
authors: A
authors: Arrivi
authors: J C
authors: JC
authors: Cámara
authors: J
authors: J
authors: Capdevila
authors: A
authors: A
authors: Gómez-España
authors: A
authors: A
authors: Lacasta
authors: J L
authors: JL
authors: Manzano
authors: M
authors: M
authors: Salgado
authors: J
authors: J
authors: Sastre
authors: E
authors: E
authors: Díaz-Rubio
mesh_terms: D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D006801:Humans; D020360:Neoadjuvant Therapy; D017410:Practice Guidelines as Topic; D012004:Rectal Neoplasms / Q000628:therapy*