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Rectal Cancer: Nonoperative Management

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Abstract

Widespread implementation of neoadjuvant treatment strategies in rectal cancer management resulted in the observation of complete tumor regression in a proportion of patients at the time of surgery. The possibility of identifying these patients with no residual disease by clinical, endoscopic, and radiological assessment could provide an opportunity for the selection of patients that could potentially avoid radical proctectomy and its associated morbidity, functional consequences, and requirement for a stoma during treatment of rectal cancer. On the other hand, keeping the rectum in situ with this nonoperative approach may result in local tumor regrowth, need for salvage resection, and potential consequences in long-term survival. In the present chapter, specific features for the selection of patients for this organ-preserving strategy are illustrated together with a detailed presentation of data related to the risk of local regrowth and long-term oncological and functional outcomes.

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Authors and Affiliations

  1. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Julio Garcia-Aguilar

  2. Department of Surgical Oncology, Angelita and Joaquim Gama Institute, Beneficencia Portuguesa de Sao Paolo, Alemao Oswaldo Cruz, Sao Paulo, Brazil

    Rodrigo Oliva Perez

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  1. Julio Garcia-Aguilar
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  2. Rodrigo Oliva Perez
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Correspondence to Julio Garcia-Aguilar .

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Editors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA

    Scott R. Steele

  2. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA

    Tracy L. Hull

  3. University of Chicago Medical Center, Chicago, IL, USA

    Neil Hyman

  4. Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA

    Justin A. Maykel

  5. Division of Gastrointestinal Surgery, University of Florida, Gainesville, FL, USA

    Thomas E. Read

  6. Department of Colon and Rectal Surgery, Ochsner Clinic, New Orleans, LA, USA

    Charles B. Whitlow

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Garcia-Aguilar, J., Perez, R.O. (2022). Rectal Cancer: Nonoperative Management. In: Steele, S.R., Hull, T.L., Hyman, N., Maykel, J.A., Read, T.E., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-66049-9_28

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