title: Evolving treatment strategies for colorectal cancer: a critical review of current therapeutic options.
abstract: 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.
authors.affiliation: Daniel C Damin, Division of Coloproctology, Department of Surgery, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS 90035-903, Brazil.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Damin
authors.affiliation: Daniel C Damin, Division of Coloproctology, Department of Surgery, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS 90035-903, Brazil.
authors.forename: Anderson R
authors.initials: AR
authors.lastname: Lazzaron
mesh_terms: D059186:Chemoradiotherapy, Adjuvant; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000401:mortality; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D018579:Patient Selection; D016896:Treatment Outcome
keywords: Colorectal cancer; Neoadjuvant chemo-radiotherapy; Rectal cancer; Sphincter preservation; Staging; Surgery