title: [Locally advanced rectal cancer management: which role for the pathologist in 2011?].
abstract: Locally advanced rectal cancers mainly correspond to lieberkünhien adenocarcinomas and are defined by T3-T4 lesions with or without regional metastatic lymph nodes. Such tumors benefit from neoadjuvant treatment combining chemotherapy and radiotherapy, followed by surgery with total mesorectum excision. Such a strategy can decrease the rate of local relapse and lead to an easier complementary surgery. The pathologist plays an important role in the management of locally advanced rectal cancer. Indeed, he is involved in the gross examination of the mesorectum excision quality and in the exhaustive sampling of the most informative areas. He also has to perform a precise histopathological analysis, including the determination of the circumferential margin or clearance and the evaluation of tumor regression. All these parameters are major prognostic factors which have to be clearly included in the pathology report. Moreover, the next challenge for the pathologist will be to determine and validate new prognostic and predictive markers, notably by using pre-therapeutic biopsies. The goal of this mini-review is to emphasize the pathologist's role in the different steps of the management of locally advanced rectal cancers and to underline its implication in the determination of potential biomarkers of aggressiveness and response.
authors.affiliation: Service de pathologie, CRLC Val-d'Aurelle, Montpellier, France. Frederic.Bibeau@montpellier.unicancer.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Bibeau
authors.forename: Anne
authors.initials: A
authors.lastname: Rullier
authors.forename: Marie-Françoise
authors.initials: MF
authors.lastname: Jourdan
authors.forename: Hélène
authors.initials: H
authors.lastname: Frugier
authors.forename: Julien
authors.initials: J
authors.lastname: Palasse
authors.forename: Cristina
authors.initials: C
authors.lastname: Leaha
authors.forename: Amélie
authors.initials: A
authors.lastname: Gudin de Vallerin
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rivière
authors.forename: Xavier
authors.initials: X
authors.lastname: Bodin
authors.forename: Véronique
authors.initials: V
authors.lastname: Perrault
authors.forename: Céline
authors.initials: C
authors.lastname: Cantos
authors.forename: Roselyne
authors.initials: R
authors.lastname: Lavaill
authors.forename: Florence
authors.initials: F
authors.lastname: Boissière-Michot
authors.forename: David
authors.initials: D
authors.lastname: Azria
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Colombo
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouanet
authors.forename: Eric
authors.initials: E
authors.lastname: Rullier
authors.forename: Yves
authors.initials: Y
authors.lastname: Panis
authors.forename: Nathalie
authors.initials: N
authors.lastname: Guedj
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D059186:Chemoradiotherapy, Adjuvant; D002864:Chromogranins / Q000032:analysis; D003102:Colloids / Q000032:analysis; D003131:Combined Modality Therapy; D019468:Disease Management; D006801:Humans; D033183:Interdisciplinary Communication; D058990:Molecular Targeted Therapy; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D010338:Pathology, Clinical; D010819:Physician's Role; D011379:Prognosis; D012004:Rectal Neoplasms / Q000737:chemistry / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D002864:Chromogranins; D003102:Colloids