Rectal cancer: French Intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO).
BACKGROUND
This document is a summary of the French Intergroup guidelines regarding the management of rectal adenocarcinoma published in February 2016.


METHODS
This collaborative work, under the auspices of most of the French medical societies involved in the management of rectal cancer, is based on the previous guidelines published in 2013. Recommendations are graded into 3 categories according to the level of evidence of data found in the literature.


RESULTS
In agreement with the ESMO guidelines (2013), non-metastatic rectal cancers have been stratified in 4 risk groups according to endoscopy, MRI or endorectal-ultrasonography. Locally-advanced tumors are limited to groups 3 and 4 (T3≥4cm or T3c-d or N1-2 or T4). These tumors are usually treated using neoadjuvant treatment and total proctectomy (TME). Adjuvant treatment depends on the pathological findings. Very early (group 1) or early (group 2) tumors are managed mainly by surgery, and organ preservation may be an option in selected cases. For metastatic tumors, the recommendations are based on less robust evidence and chemotherapy plays a major role.


CONCLUSIONS
Such recommendations are constantly being optimized and each individual case must be discussed within a Multi-Disciplinary Team.
UNICANCER Nice, France. Electronic address: jean-pierre.gerard@nice.unicancer.fr.
Jean-Pierre
JP
Gérard
APHP Paris, France.
Thierry
T
André
CHU Caen, France.
Frédéric
F
Bibeau
Institut Cancérologie Lorraine, UNICANCER Nancy, France.
Thierry
T
Conroy
CHG Orléans, France.
Jean-Louis
JL
Legoux
CHU Toulouse, France.
Guillaume
G
Portier
CHU Besançon, France.
Jean-François
JF
Bosset
CHU Reims, France.
Guillaume
G
Cadiot
CHU Reims, France.
Olivier
O
Bouché
CHU Dijon, France.
Laurent
L
Bedenne
D005500:Follow-Up Studies; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D016737:Proctocolectomy, Restorative; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy*; D012007:Rectum / Q000473:pathology
Guidelines; National recommendations; Rectal cancer