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Gastrointestinal Oncology pp 379–421Cite as

Rectal Cancer

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Abstract

The treatment of rectal cancer has changed considerably in recent years. Progress has been made both in surgery as well as in radio- and chemotherapy. Better knowledge of radial microscopic lymphatic spread within the so-called “mesorectum” has led to the use of total mesorectal excision. With this type of surgery, local control rates have been markedly increased. Technical advances in radiotherapy, and improvements in the sequenzing of radiotherapy, chemotherapy, and surgery have allowed to increase the therapeutic ratio. Moreover, additional agents, e.g., capecitabine, oxaliplatin, or irinotecan as well as targeted therapies, are currently incorporated into multimodality concepts. Moreover, advances both in pathology and imaging have further contributed to the multidisciplinary management. Evidently, the monolithic approaches, established by studies more than a decade ago, to either apply the same schedule of preoperative or postoperative 5-FU-based chemoradiotherapy to all patients with TNM stage II/III rectal cancer or to give preoperative intensive short-course RT according to the Swedish and Dutch concept for all patients with resectable rectal cancer irrespective of tumor stage and location, need to be questioned. The inclusion of different multimodal treatments into the surgical oncological concept, adapted to the tumor location and stage and to individual patient’s risk factors is mandatory. Clearly, future developments will aim at identifying and selecting patients for the ideal treatment alternatives. Thus, clinicopathological and molecular features as well as accurate preoperative imaging and postoperative surgical quality control will take an important and integrative part in multimodality treatment of rectal cancer.

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References

  • Aschele C et al (2009) Preoperative fluorouracil (FU)-based chemoradiation with and without weekly oxaliplatin in locally advanced rectal cancer: pathologic response analysis of the Studio Terapia Adiuvante Retto (STAR)-01 randomized phase III trial. J Clin Oncol (Meeting Abstracts) 27(18S):CRA4008

    Google Scholar 

  • Barbaro B et al (2009) Locally advanced rectal cancer: MR imaging in prediction of response after preoperative chemotherapy and radiation therapy. Radiology 250(3):730–739

    Article  PubMed  Google Scholar 

  • Beets-Tan RG, Beets GL (2008) Preoperative staging of rectal tumors: what is the most optimal staging method? Onkologie 31(5):222–223

    Article  PubMed  Google Scholar 

  • Bertolini F et al (2009) Neoadjuvant treatment with single-agent cetuximab followed by 5-FU, cetuximab, and pelvic radiotherapy: a phase II study in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 73(2):466–472

    Article  CAS  PubMed  Google Scholar 

  • Bipat S et al (2004) Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging – a meta-analysis. Radiology 232(3):773–783

    Article  PubMed  Google Scholar 

  • Birgisson H et al (2005) Occurrence of second cancers in patients treated with radiotherapy for rectal cancer. J Clin Oncol 23(25):6126–6131

    Article  PubMed  Google Scholar 

  • Borschitz T et al (2008) Neoadjuvant chemoradiation and local excision for T2-3 rectal cancer. Ann Surg Oncol 15(3):712–720

    Article  PubMed  Google Scholar 

  • Bosset JF et al (2006) Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med 355(11):1114–1123

    Article  CAS  PubMed  Google Scholar 

  • Braendengen M et al (2008) Randomized phase III study comparing preoperative radiotherapy with chemoradiotherapy in nonresectable rectal cancer. J Clin Oncol 26(22):3687–3694

    Article  CAS  PubMed  Google Scholar 

  • Bujko K et al (2004) Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy. Radiother Oncol 72(1):15–24

    Article  CAS  PubMed  Google Scholar 

  • Bujko K et al (2006) Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 93(10):1215–1223

    Article  CAS  PubMed  Google Scholar 

  • Cafiero F et al (2003) Randomized clinical trial of adjuvant postoperative RT vs. sequential postoperative ER plus 5-FU and levamisol in patients with stage II-III resectable rectal cancer: a final report. J Surg Oncol 83(3):140–146

    Article  CAS  PubMed  Google Scholar 

  • Calvo FA et al (2004) 18F-FDG positron emission tomography staging and restaging in rectal cancer treated with preoperative chemoradiation. Int J Radiat Oncol Biol Phys 58(2):528–535

    Article  PubMed  Google Scholar 

  • Calvo FA et al (2006) Improved incidence of pT0 downstaged surgical specimens in locally advanced rectal cancer (LARC) treated with induction oxaliplatin plus 5-fluorouracil and preoperative chemoradiation. Ann Oncol 17(7):1103–1110

    Article  CAS  PubMed  Google Scholar 

  • Camma C et al (2000) Preoperative radiotherapy for resectable rectal cancer: a meta-analysis. JAMA 284(8):1008–1015

    Article  CAS  PubMed  Google Scholar 

  • Capirci C et al (2008) Prognostic value of pathologic complete response after neoadjuvant therapy in locally advanced rectal cancer: long-term analysis of 566 ypCR patients. Int J Radiat Oncol Biol Phys 72(1):99–107

    Article  PubMed  Google Scholar 

  • Cavaliere F et al (1995) Coloanal anastomosis for rectal cancer. Long-term results at the Mayo and Cleveland Clinics. Dis Colon Rectum 38(8):807–812

    Article  CAS  PubMed  Google Scholar 

  • Ceelen W et al (2009) Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer: a systematic review and meta-analysis. Int J Cancer 124(12):2966–2972

    Article  CAS  PubMed  Google Scholar 

  • Chau I et al (2006) Neoadjuvant capecitabine and oxaliplatin followed by synchronous chemoradiation and total mesorectal excision in magnetic resonance imaging-defined poor-risk rectal cancer. J Clin Oncol 24(4):668–674

    Article  CAS  PubMed  Google Scholar 

  • Cho E et al (2004) Alcohol intake and colorectal cancer: a pooled analysis of 8 cohort studies. Ann Intern Med 140(8):603–613

    PubMed  Google Scholar 

  • Collette L et al (2007) Patients with curative resection of cT3-4 rectal cancer after preoperative radiotherapy or radiochemotherapy: does anybody benefit from adjuvant fluorouracil-based chemotherapy? A trial of the European Organisation for Research and Treatment of Cancer Radiation Oncology Group. J Clin Oncol 25(28):4379–4386

    Article  CAS  PubMed  Google Scholar 

  • Colorectal Cancer Collaborative Group (2001) Adjuvant radiotherapy for rectal cancer: a systematic overview of 8507 patients from 22 randomised trials. Lancet 358(9290):1291–1304

    Article  Google Scholar 

  • Crane CH et al (2010) Phase II Trial of neoadjuvant bevacizumab, capecitabine, and radiotherapy for locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 76(3): 824–830

    Google Scholar 

  • Debucquoy A et al (2009) Molecular response to cetuximab and efficacy of preoperative cetuximab-based chemoradiation in rectal cancer. J Clin Oncol 27(17):2751–2757

    Article  CAS  PubMed  Google Scholar 

  • den Dulk M et al (2009) Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery. Br J Surg 96(9):1066–1075

    Article  Google Scholar 

  • DiPetrillo TA et al (2008) Neoadjuvant bevacizumab, oxaliplatin, 5-fluorouracil, and radiation in clinical stage II-III rectal cancer. J Clin Oncol 26:Abstract 15041

    Google Scholar 

  • Frykholm GJ, Glimelius B, Pahlman L (1993) Preoperative or postoperative irradiation in adenocarcinoma of the rectum: final treatment results of a randomized trial and an evaluation of late secondary effects. Dis Colon Rectum 36(6):564–572

    Article  CAS  PubMed  Google Scholar 

  • Gastrointestinal Tumor Study Group (1985) Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med 312(23):1465–1472

    Article  Google Scholar 

  • Gastrointestinal Tumor Study Group (1992) Radiation therapy and fluorouracil with or without semustine for the treatment of patients with surgical adjuvant adenocarcinoma of the rectum. J Clin Oncol 10(4):549–557

    Google Scholar 

  • Gerard JP et al (2006) Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J Clin Oncol 24(28):4620–4625

    Article  PubMed  Google Scholar 

  • Gerard J et al (2009) Randomized multicenter phase III trial comparing two neoadjuvant chemoradiotherapy (CT-RT) regimens (RT45-Cap versus RT50-Capox) in patients (pts) with locally advanced rectal cancer (LARC): Results of the ACCORD 12/0405 PRODIGE 2. J Clin Oncol (Meeting Abstracts) 27(18S):LBA4007

    Google Scholar 

  • Glimelius B et al (2003) A systematic overview of radiation therapy effects in rectal cancer. Acta Oncol 42(5–6):476–492

    Article  PubMed  Google Scholar 

  • Glynne-Jones R, Anyemene N (2009) Histologic response grading after chemoradiation in locally advanced rectal cancer: a proposal for standardized reporting. Int J Radiat Oncol Biol Phys 73(4):971–973

    Article  PubMed  Google Scholar 

  • Glynne-Jones R et al (2006) Neoadjuvant chemotherapy prior to preoperative chemoradiation or radiation in rectal cancer: should we be more cautious? Br J Cancer 94(3):363–371

    Article  CAS  PubMed  Google Scholar 

  • Grady WM, Carethers JM (2008) Genomic and epigenetic instability in colorectal cancer pathogenesis. Gastroenterology 135(4):1079–1099

    Article  CAS  PubMed  Google Scholar 

  • Greene FL, Stewart AK, Norton HJ (2004) New tumor-node-metastasis staging strategy for node-positive (stage III) rectal cancer: an analysis. J Clin Oncol 22(10):1778–1784

    Article  PubMed  Google Scholar 

  • Guerrieri M et al (2008) Transanal endoscopic microsurgery for the treatment of selected patients with distal rectal cancer: 15 years experience. Surg Endosc 22(9):2030–2035

    Article  CAS  PubMed  Google Scholar 

  • Gunderson LL et al (2004) Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis. J Clin Oncol 22(10):1785–1796

    Article  PubMed  Google Scholar 

  • Habr-Gama A, Perez RO (2009) Non-operative management of rectal cancer after neoadjuvant chemoradiation. Br J Surg 96(2):125–127

    Article  CAS  PubMed  Google Scholar 

  • Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1(8496):1479–1482

    Article  CAS  PubMed  Google Scholar 

  • Hermanek P et al (2003) The pathological assessment of mesorectal excision: implications for further treatment and quality management. Int J Colorectal Dis 18(4):335–341

    CAS  PubMed  Google Scholar 

  • Holm T et al (2007) Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer. Br J Surg 94(2):232–238

    Article  CAS  PubMed  Google Scholar 

  • Horisberger K et al (2009) Cetuximab in combination with capecitabine, irinotecan, and radiotherapy for patients with locally advanced rectal cancer: results of a Phase II MARGIT trial. Int J Radiat Oncol Biol Phys 74(5):1487–1493

    Article  CAS  PubMed  Google Scholar 

  • Huerta S (2008) Recent advances in the molecular diagnosis and prognosis of colorectal cancer. Expert Rev Mol Diagn 8(3):277–288

    Article  CAS  PubMed  Google Scholar 

  • Ishiguro S et al (2009) Pelvic exenteration for clinical T4 rectal cancer: oncologic outcome in 93 patients at a single institution over a 30-year period. Surgery 145(2):189–195

    Article  PubMed  Google Scholar 

  • Jemal A et al (2009) Cancer statistics. CA Cancer J Clin 59(4):225–249

    Article  PubMed  Google Scholar 

  • Kalofonos HP et al (2008) A randomised phase III trial of adjuvant radio-chemotherapy comparing Irinotecan, 5FU and Leucovorin to 5FU and Leucovorin in patients with rectal cancer: a Hellenic Cooperative Oncology Group Study. Eur J Cancer 44(12):1693–1700

    Article  CAS  PubMed  Google Scholar 

  • Kapiteijn E et al (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345(9):638–646

    Article  CAS  PubMed  Google Scholar 

  • Krook JE et al (1991) Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324(11):709–715

    Article  CAS  PubMed  Google Scholar 

  • Lahaye MJ et al (2008) USPIO-enhanced MR imaging for nodal staging in patients with primary rectal cancer: predictive criteria. Radiology 246(3):804–811

    Article  PubMed  Google Scholar 

  • Langer C et al (2003) Surgical cure for early rectal carcinoma and large adenoma: transanal endoscopic microsurgery (using ultrasound or electrosurgery) compared to conventional local and radical resection. Int J Colorectal Dis 18(3):222–229

    CAS  PubMed  Google Scholar 

  • Lashner BA et al (1997) The effect of folic acid supplementation on the risk for cancer or dysplasia in ulcerative colitis. Gastroenterology 112(1):29–32

    Article  CAS  PubMed  Google Scholar 

  • Law WL et al (2007) Anastomotic leakage is associated with poor long-term outcome in patients after curative colorectal resection for malignancy. J Gastrointest Surg 11(1):8–15

    Article  PubMed  Google Scholar 

  • Learn PA, Kahlenberg MS (2009) Hereditary colorectal cancer syndromes and the role of the surgical oncologist. Surg Oncol Clin N Am 18(1):121–144, ix

    Google Scholar 

  • Leslie A et al (2002) The colorectal adenoma-carcinoma sequence. Br J Surg 89(7):845–860

    Article  CAS  PubMed  Google Scholar 

  • Lezoche G et al (2008) A prospective randomized study with a 5-year minimum follow-up evaluation of transanal endoscopic microsurgery versus laparoscopic total mesorectal excision after neoadjuvant therapy. Surg Endosc 22(2):352–358

    Article  CAS  PubMed  Google Scholar 

  • Lopez-Kostner F et al (1998) Total mesorectal excision is not necessary for cancers of the upper rectum. Surgery 124(4):612–617; discussion 617–618

    Google Scholar 

  • Machiels JP et al (2007) Phase I/II study of preoperative cetuximab, capecitabine, and external beam radiotherapy in patients with rectal cancer. Ann Oncol 18(4):738–744

    Article  PubMed  Google Scholar 

  • Marijnen CA et al (2008) Preoperative chemoradiotherapy regimen with capecitabine and bevacizumab in locally advanced rectal cancer: a feasibility study of the Dutch Colorectal Cancer Group (DCCG). J Clin Oncol 26:Abstract 15040

    Google Scholar 

  • Marquardt F et al (2009) Molecular targeted treatment and radiation therapy for rectal cancer. Strahlenther Onkol 185(6):371–378

    Article  PubMed  Google Scholar 

  • Martling A et al (2002) The surgeon as a prognostic factor after the introduction of total mesorectal excision in the treatment of rectal cancer. Br J Surg 89(8):1008–1013

    Article  CAS  PubMed  Google Scholar 

  • Matthiessen P et al (2007) Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg 246(2):207–214

    Article  PubMed  Google Scholar 

  • MERCURY Study Group (2007) Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology 243(1):132–139

    Article  Google Scholar 

  • Minsky BD et al (1992) Enhancement of radiation-induced downstaging of rectal cancer by fluorouracil and high-dose leucovorin chemotherapy. J Clin Oncol 10(1):79–84

    CAS  PubMed  Google Scholar 

  • Moriya Y et al (2003) Aggressive surgical treatment for patients with T4 rectal cancer. Colorectal Dis 5(5):427–431

    Article  CAS  PubMed  Google Scholar 

  • Nagtegaal ID, Quirke P (2008) What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol 26(2):303–312

    Article  PubMed  Google Scholar 

  • Nagtegaal ID et al (2005) Low rectal cancer: a call for a change of approach in abdominoperineal resection. J Clin Oncol 23(36):9257–9264

    Article  PubMed  Google Scholar 

  • NIH consensus conference (1990) Adjuvant therapy for patients with colon and rectal cancer. JAMA 264(11):1444–1450

    Article  Google Scholar 

  • Nivatvongs S (2000) Surgical management of early colorectal cancer. World J Surg 24:1052–1055

    Article  CAS  PubMed  Google Scholar 

  • Norat T et al (2005) Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition. J Natl Cancer Inst 97(12):906–916

    Article  PubMed  Google Scholar 

  • O’Connell MJ et al (1994) Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med 331(8):502–507

    Article  PubMed  Google Scholar 

  • Peeters KC et al (2007) The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma. Ann Surg 246(5):693–701

    Article  PubMed  Google Scholar 

  • Puli SR et al (2009) Accuracy of endoscopic ultrasound to diagnose nodal invasion by rectal cancers: a meta-analysis and systematic review. Ann Surg Oncol 16(5):1255–1265

    Article  PubMed  Google Scholar 

  • Quirke P et al (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 2(8514):996–999

    Article  CAS  PubMed  Google Scholar 

  • Quirke P et al (2007) The future of the TNM staging system in colorectal cancer: time for a debate? Lancet Oncol 8(7):651–657

    Article  PubMed  Google Scholar 

  • Quirke P et al (2009) Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet 373(9666):821–828

    Article  PubMed  Google Scholar 

  • Radu C et al (2008) Short-course preoperative radiotherapy with delayed surgery in rectal cancer – a retrospective study. Radiother Oncol 87(3):343–349

    Article  PubMed  Google Scholar 

  • Rodel C, Sauer R (2007) Integration of novel agents into combined-modality treatment for rectal cancer patients. Strahlenther Onkol 183(5):227–235

    Article  PubMed  Google Scholar 

  • Rodel C et al (2007) Multicenter phase II trial of chemoradiation with oxaliplatin for rectal cancer. J Clin Oncol 25(1):110–117

    Article  PubMed  Google Scholar 

  • Rodel C et al (2008) Phase I-II trial of cetuximab, capecitabine, oxaliplatin, and radiotherapy as preoperative treatment in rectal cancer. Int J Radiat Oncol Biol Phys 70(4):1081–1086

    Article  PubMed  Google Scholar 

  • Rödel C et al (2005) Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer. J Clin Oncol 23(34):8688–8696

    Article  PubMed  Google Scholar 

  • Roh MS et al (2009) Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. J Clin Oncol 27(31):5124–5130

    Article  PubMed  Google Scholar 

  • Rutten HJ et al (2008) Controversies of total mesorectal excision for rectal cancer in elderly patients. Lancet Oncol 9(5):494–501

    Article  PubMed  Google Scholar 

  • Sauer R et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351(17):1731–1740

    Article  CAS  PubMed  Google Scholar 

  • Sebag-Montefiore D et al (2009) Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 373(9666):811–820

    Article  PubMed  Google Scholar 

  • Smalley SR et al (2006) Phase III trial of fluorouracil-based chemotherapy regimens plus radiotherapy in postoperative adjuvant rectal cancer: GI INT 0144. J Clin Oncol 24(22):3542–3547

    Article  CAS  PubMed  Google Scholar 

  • Sterk P et al (2000) Vascular organization in the mesorectum: angiography of rectal resection specimens. Int J Colorectal Dis 15(4):225–228

    Article  CAS  PubMed  Google Scholar 

  • Swedish Rectal Cancer Trial (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336(14):980–987

    Article  Google Scholar 

  • Tepper JE et al (2002) Adjuvant therapy in rectal cancer: analysis of stage, sex, and local control – final report of intergroup 0114. J Clin Oncol 20(7):1744–1750

    Article  CAS  PubMed  Google Scholar 

  • Tveit KM et al (1997) Randomized controlled trial of postoperative radiotherapy and short-term time-scheduled 5-fluorouracil against surgery alone in the treatment of Dukes B and C rectal cancer. Norwegian Adjuvant Rectal Cancer Project Group. Br J Surg 84(8):1130–1135

    Article  CAS  PubMed  Google Scholar 

  • Valentini V et al (2008) Evidence and research in rectal cancer. Radiother Oncol 87(3):449–474

    Article  PubMed  Google Scholar 

  • Valentini V et al (2009) Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2). Radiother Oncol 92(2):148–163

    Article  PubMed  Google Scholar 

  • Watanabe T et al (2008) Lateral pelvic lymph node dissection or chemoradiotherapy: which is the procedure of choice to reduce local recurrence rate in lower rectal cancer? Ann Surg 248(2):342–343; author reply 343

    Google Scholar 

  • West NP et al (2008) Evidence of the oncologic superiority of cylindrical abdominoperineal excision for low rectal cancer. J Clin Oncol 26(21):3517–3522

    Article  PubMed  Google Scholar 

  • Whittemore AS et al (1990) Diet, physical activity, and colorectal cancer among Chinese in North America and China. J Natl Cancer Inst 82(11):915–926

    Article  CAS  PubMed  Google Scholar 

  • Willett CG et al (2004) Direct evidence that the VEGF-specific antibody bevacizumab has antivascular effects in human rectal cancer. Nat Med 10(2):145–147

    Article  CAS  PubMed  Google Scholar 

  • Willett CG et al (2009) Efficacy, safety, and biomarkers of neoadjuvant bevacizumab, radiation therapy, and fluorouracil in rectal cancer: a multidisciplinary phase II study. J Clin Oncol 27(18):3020–3026

    Article  CAS  PubMed  Google Scholar 

  • Williams CS, Mann M, DuBois RN (1999) The role of cyclooxygenases in inflammation, cancer, and development. Oncogene 18(55):7908–7916

    Article  CAS  PubMed  Google Scholar 

  • Wittekind Ch, Henson DE, Hutter RVP, Sobin LH (eds) (2001) TNM supplement. A commentary on uniform use, 2nd edn. Wiley, New York

    Google Scholar 

  • Wolmark N et al (2000) Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National Surgical Adjuvant Breast and Bowel Project Protocol R-02. J Natl Cancer Inst 92(5):388–396

    Article  CAS  PubMed  Google Scholar 

  • Yamada K et al (2002) Pelvic exenteration and sacral resection for locally advanced primary and recurrent rectal cancer. Dis Colon Rectum 45(8):1078–1084

    Article  PubMed  Google Scholar 

  • Yee J (2009) CT colonography: techniques and applications. Radiol Clin North Am 47(1):133–145

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiotherapy and Oncology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Claus Rödel

  2. Department of Haematology and Oncology, University Halle-Wittenberg, Halle, Germany

    Dirk Arnold

  3. Department of General Surgery, University of Göttingen, Göttingen, Germany

    Torsten Liersch

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  1. Claus Rödel
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  2. Dirk Arnold
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  3. Torsten Liersch
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Correspondence to Claus Rödel .

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Editors and Affiliations

  1. Div. Medical Oncology, University of British Columbia, West 10th Avenue 600, Vancouver, V5Z 4E6, British Columbia, Canada

    Charles D. Blanke

  2. FB 19 Zentrum der Radiologie, Klinik f. Strahlentherapie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany

    Claus Rödel

  3. Evanston Northwestern Healthcare, Northwestern University, Ridge Ave. 2650, Evanston, 60201, Illinois, USA

    Mark S. Talamonti

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Rödel, C., Arnold, D., Liersch, T. (2011). Rectal Cancer. In: Blanke, C., Rödel, C., Talamonti, M. (eds) Gastrointestinal Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-13306-0_13

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