Rectal cancer

Question 1

local surgical resection alone for rectal

Answer 1

only T1N0 (invades only submucosa but not muscular propr.)

Question 2

total mesorectal excision for rectal

Answer 2

preferred for all cancers except T1. preserves natural tissue planes to reduce seeding.

Question 3

combined modality therapy for rectal

Answer 3

prolonged PREOPERATIVE chemoRT is best way to go. infusion 5-FU or BID xeloda + RT 50.4Gy. (equivalent). No benefit to adding second agent.

Question 4

alternatives for RT for pre-op rectal cancer

Answer 4

either 5x5Gy Sauer protocol followed by chemoRT, or prolonged chemoRT 50.4Gy+5-FU/cape are acceptable.