title: Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference.
abstract: BACKGROUND
  The last 30 years have witnessed a significant increase in the diagnosis of early-stage rectal cancer and the development of new strategies to reduce the treatment-related morbidity. Currently, there is no consensus on the definition of early rectal cancer (ERC), and the best management of ERC has not been yet defined. The European Association for Endoscopic Surgery in collaboration with the European Society of Coloproctology developed this consensus conference to provide recommendations on ERC diagnosis, staging and treatment based on the available evidence.
  
  
  METHODS
  A multidisciplinary group of experts selected on their clinical and scientific expertise was invited to critically review the literature and to formulate evidence-based recommendations by the Delphi method. Recommendations were discussed at the plenary session of the 14th World Congress of Endoscopic Surgery, Paris, 26 June 2014, and then posted on the EAES website for open discussion.
  
  
  RESULTS
  Tumour biopsy has a low accuracy. Digital rectal examination plays a key role in the pre-operative work-up. Magnification chromoendoscopy, endoscopic ultrasound and magnetic resonance imaging are complementary staging modalities. Endoscopic submucosal dissection and transanal endoscopic microsurgery are the two established approaches for local excision (LE) of selected ERC. The role of all organ-sparing approaches including neoadjuvant therapies followed by LE should be formally assessed by randomized controlled trials. Rectal resection and total mesorectal excision is indicated in the presence of unfavourable features at the pathological evaluation of the LE specimen. The laparoscopic approach has better short-term outcomes and similar oncologic results when compared with open surgery.
  
  
  CONCLUSIONS
  The management of ERC should always be based on a multidisciplinary approach, aiming to increase the rate of organ-preserving procedures without jeopardizing survival.
authors.affiliation: Department of Surgical Sciences, University of Torino, Corso A. M. Dogliotti 14, 10126, Turin, Italy, mario.morino@unito.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Morino
authors.forename: Mauro
authors.initials: M
authors.lastname: Risio
authors.forename: Simon
authors.initials: S
authors.lastname: Bach
authors.forename: Regina
authors.initials: R
authors.lastname: Beets-Tan
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Bujko
authors.forename: Yves
authors.initials: Y
authors.lastname: Panis
authors.forename: Philip
authors.initials: P
authors.lastname: Quirke
authors.forename: Bjorn
authors.initials: B
authors.lastname: Rembacken
authors.forename: Eric
authors.initials: E
authors.lastname: Rullier
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
authors.forename: Tonia
authors.initials: T
authors.lastname: Young-Fadok
authors.forename: Marco Ettore
authors.initials: ME
authors.lastname: Allaix
mesh_terms: D059186:Chemoradiotherapy, Adjuvant; D003697:Delphi Technique; D006801:Humans; D010535:Laparoscopy; D020360:Neoadjuvant Therapy; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000628:therapy; D012007:Rectum / Q000601:surgery