Clinical Information in Rectal Cancer

As cancer care becomes increasingly complex and multidisciplinary, the availability of timely and complete clinical information is critical to decisionmaking. Complete clinical information is particularly relevant in the care of stages i–iii rectal cancer: surgery, radiotherapy, and chemotherapy all play a major role, and the selection of such therapies is of utmost importance. Surgery for nonmetastatic rectal cancer has evolved significantly since the early 1980s, with recognition of the importance of total mesorectal excision (tme), first described by Heald and Ryall in 19861. Notwithstanding the variability in surgical outcomes that have persisted2,3, tme has been recognized as the standard of care in rectal cancer surgery4. Moreover, decisions regarding the use of neoadjuvant or adjuvant radiotherapy in rectal cancer may be—at least in part—influenced by the likelihood of complete resection of non-involved mesorectal fascia with a high-quality tme5. Like surgery, neoadjuvant and adjuvant radiotherapy with or without chemotherapy in rectal cancer has also evolved, having been the subject of multiple randomized clinical trials6,7. ABSTRACT