[Locally advanced rectal cancer - Standards and new multimodality treatment concepts]

Treatment strategies for locally advanced rectal cancer are changing dramatically. The treatment recommended in the guidelines for locally advanced tumors of neoadjuvant radio(chemo)therapy (RChT), followed by surgery and, if necessary, adjuvant therapy, are increasingly be abandoned in favor of the following concepts: (i) prolonged neoadjuvant (RChT (i. e. "more chemotherapy before resection", referred to as total neoadjuvant therapy, TNT); (ii) omission of radiotherapy in tumors with a low risk of local recurrence; (iii) organ preservation in patients with a complete clinical response after neoadjuvant radiochemotherapy. Herein, current strategies and study concepts are to be discussed based on the guideline-based status quo.