title: Current controversies in neoadjuvant chemoradiation of rectal cancer.
abstract: Total mesorectal excision with preoperative radiation and chemotherapy provide the lowest local recurrence rates for rectal cancer. Timing of surgery after preoperative chemoradiation is being increased to optimize tumor downstaging. In cases of complete clinical response from chemoradiation, permissive observation without resection is being investigated. Significant anorectal dysfunction results from low anterior resection and radiation. Good prognostic tumor characteristics are being investigated with the aim of selecting cases for whom preoperative radiation may be avoided. Preoperative and postoperative radiation provides improved local cancer control for superficial cancers removed by local excision.
authors.affiliation: Department of Surgery, St. Paul's Hospital, University of British Columbia, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. Electronic address: tphang@providencehealth.bc.ca.
authors.forename: P Terry
authors.initials: PT
authors.lastname: Phang
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
mesh_terms: D059248:Chemoradiotherapy; D006801:Humans; D020360:Neoadjuvant Therapy; D011379:Prognosis; D012004:Rectal Neoplasms / Q000628:therapy*; D012307:Risk Factors
keywords: Complete pathologic response; Long course; Neo-adjuvant chemoradiation; Rectal cancer; Short course