title: Management of rectal cancer: the 2016 French guidelines.
abstract: OBJECTIVE
  Rectal cancer is a malignant disease requiring multidisciplinary management. In view of the increasing number of studies published over the past decade, a comprehensive update is required to draw recommendations for clinical practice mandated by the French Research Group of Rectal Cancer Surgery and the French National Coloproctology Society.
  
  
  METHODS
  Seven questions summarizing the treatment of rectal cancer were selected. A search for evidence in the literature from January 2004 to December 2015 was performed. A drafting committee and a large group of expert reviewers contributed to validate the statements.
  
  
  RESULTS
  Recommendations include the indications for neoadjuvant therapy, the quality criteria for surgical resection, the management of postoperative disordered function, the role of local excision in early rectal cancer, the place of conservative strategies after neoadjuvant treatment, the management of synchronous liver metastases and the indications for adjuvant therapy. A level of evidence was assigned to each statement.
  
  
  CONCLUSIONS
  The current clinical practice guidelines are useful for the treatment of rectal cancer. Some statements require a higher level of evidence due to a lack of studies.
authors: Department of Digestive and Oncologic Surgery, University Hospital of Besancon, Franche-Comté University Besancon, Besancon, France.
authors: Z
authors: Z
authors: Lakkis
authors: Department of Digestive and Hepato-Pancreato-Biliary Surgery, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors: G
authors: G
authors: Manceau
authors: Department of Digestive Surgery, Rouen University Hospital, Rouen, France.
authors: V
authors: V
authors: Bridoux
authors: Department of Digestive and Oncologic Surgery, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, University Institute of Cancerology (Paris VI), Pierre and Marie Curie University, Paris, France.
authors: A
authors: A
authors: Brouquet
authors: Department of Colorectal and Oncological Surgery, Purpan Hospital and Toulouse III University, Toulouse, France.
authors: S
authors: S
authors: Kirzin
authors: Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University Paris VII, Clichy, France.
authors: L
authors: L
authors: Maggiori
authors: Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France.
authors: C
authors: C
authors: de Chaisemartin
authors: Department of Digestive Surgery, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors: J H
authors: JH
authors: Lefevre
authors: Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University Paris VII, Clichy, France.
authors: Y
authors: Y
authors: Panis
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D001003:Anal Canal; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000069287:Capecitabine / Q000627:therapeutic use; D059248:Chemoradiotherapy; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods*; D003125:Colostomy; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005472:Fluorouracil / Q000627:therapeutic use; D005602:France; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008197:Lymph Node Excision; D059146:Metastasectomy; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments; D010388:Pelvis; D011183:Postoperative Complications / Q000628:therapy; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*; D012007:Rectum / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents; D000069287:Capecitabine; D005472:Fluorouracil
keywords: Rectal cancer; chemotherapy; guidelines; local excision; radiotherapy; total mesorectal excision (TME)