Alignment of Patient Preference, Recurrence Risk and Therapeutic Strategies in Localized Rectal Cancer

Dear Colleagues,

The management of localized rectal cancer is complex and requires thoughtful consideration of the risks of local and distant recurrence, the acute and long term toxicities of therapy and the potential for organ preservation.  It is truly a multi-disciplinary endeavor with important contributions from gastroenterologists, radiologists, pathologists, medical and radiation oncologists, colorectal surgeons, and of course, patients. 

Over the past 40 years, improvements in surgical technique (TME) and neoadjuvant (chemo)radiation have significantly reduced local recurrence rates, while distant recurrence rates have remained static. In an effort to improve outcomes, clinical trial design has trended toward administering total neoadjuvant therapy (TNT), including personalized strategies based on risk and biomarker status.  Equally important, sphincter-sparing strategies have gained enthusiasm in clinical trials and clinical practice.

In this special issue, we explore important topics ranging from staging investigations and MRI risk stratification, prognostic and predictive pathologic/molecular factors, and the important advances in surgical technique and non-operative strategies. Furthermore, we investigate the evolution of modern day radiation approaches aimed at improving outcomes while minimizing toxicity and discuss the results of innovative TNT clinical trials that explore the sequencing of radiation and systemic therapies.

Dr. Michael Vickers
Guest Editor

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• rectal cancer
• multi-disciplinary approach
• gastroenterology
• radiology
• pathology
• medical and radiation oncology
• colorectal surgeons
• staging investigations
• MRI
• prognostic factors
• surgical technique
• neoadjuvant therapy