| With the development of minimal invasive surgical techniques, better understanding of surgical anatomy and concept of curative resection for rectal cancer, functional and oncologic outcomes after surgical treatment for rectal cancer become a better than before. The local staging of the rectal cancer based on MRI has developed and studied about high risk factors and predicted earlier recurrence, so called we can pick up the high risk patients and recommend neoadjuvant treatment for that group of patient. There have been a couple of large patient cohort based clinical studies regarding sequence of treatment with respect to the radiation and surgery including short course or long course etc. Nowadays, Molecular subtyping based classification for the colorectal cancer has been performed and organ preservation in good responder after preoperative chemoradiation treatment as well was suggested. Herein I would like to address a very challenging issues based on current treatment strategy on the point of view the oncologic outcomes and surgery related complication. Furthermore, cost and effectiveness on patient side in case who need preoperative chemoradiation therapy in locally advanced rectal cancer will be also addressed. In other words, we must try to rearm current available treatment modalities and plan a treatment strategy based on accumulated our experiences. Here I would like to review and introduce currently ongoing updated treatment strategy and share our ideas and experience with others to increase oncologic outcomes and decrease radiation related toxicities. |
