Surgical adjuvant therapy of rectal cancer

Surgery is the preferred method of curative therapy for carcinoma of the rectum. However, in spite of complete gross tumor resection, many patients with locally advanced tumors will experience recurrence of malignant disease in the pelvis and/or distant metastases. This article summarizes the roles of radiotherapy and chemotherapy, administered alone and in combination, as surgical adjuvant treatment for patients with resectable rectal cancer. A biostatistical overview is presented. It is concluded that strong evidence exists supporting the efficacy of combined postoperative radiotherapy and chemotherapy. Further clinical trials are indicated to determine the optimum chemotherapy regimen, sequence, and duration of the therapy.