[Rectal carcinoma. Optimizing treatment by neoadjuvant and adjuvant therapy?]

Despite of improvement of results in rectum cancer treatment after systematical introduction of total mesorectal excision as a standard procedure to control the compartment disease, surgical radicality may be limited in cases with large tumours in ventral position because of eccentric location of the rectum in the perirectal fat. In these cases (neo)adjuvant treatment with a 45-54 Gy dose radiotherapy and 5 FU-based chemotherapy seems to be useful to minimize local recurrence and distant metastases and also to provide a better outcome.