Treatment strategy for rectal cancer in MD Anderson Cancer Center

Goals in surgical treatment for rectal cancer are not only oncologic cure but organ preservation and sexual/urinary functional preservation. With recent development of total neoadjuvant therapy, various regimens are available. For total neoadjuvant therapy, options include induction and/or consolidation chemotherapy. For radiotherapy, either short course radiotherapy or long-course chemoradiotherapy are available. In patients who achieved clinical complete response, nonoperative management with careful surveillance is widely accepted as an alternative approach to TME. For surgical resection, recent studies demonstrated the oncologic benefits of lateral node dissection combined with neoadjuvant therapy in lateral node positive rectal cancer, and this procedure is rapidly recognized in the Western world. In the era that such variable oncologic and surgical strategies are available, surgeons need to understand advantages and limitations of each option to formulate the best treatment plan for each patient. Multidisciplinary conference plays an important role for decision making.
In this presentation, current strategy for rectal cancer in MD Anderson Cancer Center is introduced to discuss how to formulate the best oncologic care.