Journal of Gastrointestinal Surgery

, Volume 17, Issue 10, pp 1863–1868 | Cite as

Multidisciplinary Management of Rectal Cancer: the OSTRICH

  • David W. DietzEmail author
  • on behalf of the Consortium for Optimizing Surgical Treatment of Rectal Cancer (OSTRiCh)
Evidence-Based Current Surgical Practice



Disparity exists in outcomes for rectal cancer patients in the US. Similar problems in several European countries have been addressed by the creation of national networks of rectal cancer centers of excellence (CoEs) that follow evidence-based care pathways and specified protocols of care and process and are certified by regular external validation.


This paper reviews the current status of rectal cancer care in the US and examines the evidence for multidisciplinary rectal cancer management. A US rectal cancer CoE system based on the existing UK model is proposed.


A literature search was performed for publications related to US rectal cancer outcomes, multidisciplinary management of rectal cancer, and European rectal cancer programs.


US rectal cancer outcomes are highly variable. The majority of US rectal cancer patients are treated by generalists in low-volume hospitals. Current evidence supports five main principles of rectal cancer care that have been incorporated into European rectal cancer CoE programs. These programs have dramatically improved rectal cancer outcomes in Scandanavian countries and the UK.


A similar CoE program should be established in the US to improve the outcomes of rectal cancer patients.


Rectal cancer Centers of excellence Multidisciplinary management Multidisciplinary team OSTRiCH Total mesorectal excision 



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Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • David W. Dietz
    • 1
    • 2
    Email author
  • on behalf of the Consortium for Optimizing Surgical Treatment of Rectal Cancer (OSTRiCh)
  1. 1.Department of Colorectal Surgery, Digestive Disease InstituteCleveland ClinicClevelandUSA
  2. 2.ClevelandUSA

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