Challenges in the multimodality treatment of rectal cancer

Abstract

Remaining questions and current goals in the treatment of rectal cancer include optimizing staging accuracy, establishing the optimal neoadjuvant strategy to be implemented in the different stages of rectal cancer and possibly leading to the evidence-based introduction of organ sparing and non-operative strategies in selected patients. Furthermore, adverse effects of new multi-modality treatments need to be investigated to properly inform patients. Correlating histopathological response to outcome will provide information on efficacy of new neoadjuvant therapies, factors governing distant metastases and potential consequences of scaling down treatment approaches to avoid surgery. The aim of this thesis, addressing the different modalities, was to evaluate these aspects concerning the multidisciplinary treatment of rectal cancer in general, with the focus on patients with locally advanced rectal cancer in particular