Should Upfront Chemotherapy Precede Preoperative Chemoradiotherapy and Surgery in Locally Advanced Rectal Cancer?

  • Carlos Fernandez-Martos
  • Javier Gallego
  • Thomas J George


Treatment of micrometastasis should now be the focus of major interest in the treatment of locally advanced rectal cancer because distant metastases remain the leading cause of mortality in this population. In stage II and III rectal cancer, even in modern series, after preoperative treatment with short-course radiotherapy (SCRT) or chemoradiation (CRT) and total mesorectal excision (TME) with or without adjuvant chemotherapy (CT), 5-year distant relapse is about 35%, and local relapses are about 8% [1]. However, the role of adjuvant CT after CRT is still controversial.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  • Carlos Fernandez-Martos
    • 1
  • Javier Gallego
    • 2
  • Thomas J George
    • 3
  1. 1.Fundacion Instituto Valenciano de OncologiaValenciaSpain
  2. 2.Hospital General Universitario ElcheAlicanteSpain
  3. 3.University of Florida Health Cancer CenterGainesvilleUSA

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