[{"data":1,"prerenderedAt":93},["ShallowReactive",2],{"media-slots-en":3,"wiki-item-en-rectal-cancer":61},{"about.hero":4,"about.video":6,"about.video-cover":8,"charity.hero":10,"contact.hero":12,"evidence.hero":14,"footer.qr-blood":16,"footer.qr-mini":18,"footer.qr-official":20,"footer.qr-solid":22,"guide.hero":24,"home.hero":26,"home.news-featured":28,"home.story-featured":30,"news.hero":32,"news.lead":34,"news.thumb":36,"stories.cover":41,"stories.hero":48,"stories.lead":50,"wiki.cat":52,"wiki.detail-hero":57,"wiki.hero":59},[5],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fpc_banner\u002F%E5%85%B3%E4%BA%8E%E5%8D%9A%E5%8C%BB%E5%90%8C%E8%A1%8C_en.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[7],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fabout\u002F%E9%A3%9E%E4%B9%A620260729-233252_compressed.mp4",[9],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fabout\u002F%E9%A3%9E%E4%B9%A620260729-233252_frame1.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[11],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fpc_banner\u002F%E5%85%AC%E7%9B%8A%E8%B5%84%E6%BA%90%E9%93%BE%E6%8E%A5_en.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[13],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fbytx-pc-uploads\u002F2026\u002F08\u002Fbde8f2354d29ffca7dcfe395ef4711b2.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[15],"https:\u002F\u002Fwww.yyhmedical.com\u002Fimages\u002Fevidence\u002Fhero.jpg",[17],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fabout\u002Fqr-blood.png?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[19],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fabout\u002Fqr-mini.png?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[21],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fabout\u002Fqr-official.png?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[23],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fabout\u002Fqr-solid.png?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[25],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fpc_banner\u002F%E7%96%BE%E7%97%85%E7%9F%A5%E8%AF%86%E5%BA%93_en.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[27],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fpc_banner\u002F%E9%A6%96%E9%A1%B5_en.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[29],"\u002Fimages\u002Fhome\u002Fnews-featured.jpg",[31],"\u002Fimages\u002Fhome\u002Fstory-featured.jpg",[33],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fpc_banner\u002F%E6%82%A3%E5%8F%8B%E5%85%B3%E6%B3%A8_en.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[35],"\u002Fimages\u002Fnews\u002Flead.jpg",[37,38,39,40],"\u002Fimages\u002Fnews\u002Fn1.jpg","\u002Fimages\u002Fnews\u002Fn2.jpg","\u002Fimages\u002Fnews\u002Fn3.jpg","\u002Fimages\u002Fnews\u002Fn4.jpg",[42,43,44,45,46,47],"\u002Fimages\u002Fstories\u002Fs1.jpg","\u002Fimages\u002Fstories\u002Fs2.jpg","\u002Fimages\u002Fstories\u002Fs3.jpg","\u002Fimages\u002Fstories\u002Fs4.jpg","\u002Fimages\u002Fstories\u002Fs5.jpg","\u002Fimages\u002Fstories\u002Fs6.jpg",[49],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fpc_banner\u002F%E6%82%A3%E8%80%85%E6%95%85%E4%BA%8B_en.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",[51],"\u002Fimages\u002Fstories\u002Flead.jpg",[53,54,55,56],"\u002Fimages\u002Fwiki\u002Fcat-1.jpg","\u002Fimages\u002Fwiki\u002Fcat-2.jpg","\u002Fimages\u002Fwiki\u002Fcat-3.jpg","\u002Fimages\u002Fwiki\u002Fcat-4.jpg",[58],"\u002Fimages\u002Fwiki\u002Fdetail-hero.jpg",[60],"https:\u002F\u002Fgaobo-byh-h5.oss-cn-beijing.aliyuncs.com\u002Fstatic\u002Fpc_banner\u002F%E6%8A%97%E7%99%8C%E7%99%BE%E7%A7%91_en.jpg?x-oss-process=image\u002Fresize,limit_1,w_1600\u002Fquality,q_80\u002Fformat,webp",{"slug":62,"category":63,"categoryName":64,"title":65,"summary":66,"toc":67,"ymyl":90,"hasAlternate":92,"updatedAt":73},"rectal-cancer","solid","Solid Tumors","Rectal Cancer","Rectal cancer is a malignancy that develops in the rectum and is part of the broader group of colorectal cancers. Most rectal cancers are adenocarcinomas.\nEarly rectal cancer may cause few or no symptoms. As the disease progresses, patients may notice rectal bleeding, changes in bowel habits, a feeling of incomplete evacuation, narrowing of the stool, abdominal discomfort, or unexplained weight loss.",[68,74,78,82,86],{"key":69,"title":70,"html":71,"icon":72,"updatedAt":73},"","Overview","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">The rectum is the final part of the large intestine, connecting the sigmoid colon to the anal canal.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Although rectal and colon cancers are both colorectal cancers, rectal cancer is managed somewhat differently because the rectum lies deep within the pelvis close to structures such as the bladder, prostate, vagina, sacrum, and pelvic nerves.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Most rectal cancers are adenocarcinomas.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Modern treatment planning considers not only TNM stage but also pelvic MRI findings, including the relationship of the tumor to the mesorectal fascia, extramural vascular invasion, lymph nodes, and the distance between the tumor and the anal sphincter.\u003C\u002Fspan>\u003C\u002Fp>","⚕️","2026-09-19",{"key":69,"title":75,"html":76,"icon":77,"updatedAt":73},"Causes and Risk Factors","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Rectal cancer usually develops through a combination of genetic, age-related, lifestyle, and medical factors rather than from a single cause.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Risk factors for colorectal cancer include increasing age, a personal or family history of colorectal cancer or adenomatous polyps, inflammatory bowel disease, inherited syndromes such as Lynch syndrome and familial adenomatous polyposis, smoking, heavy alcohol use, obesity, physical inactivity, certain dietary patterns, and type 2 diabetes.\u003C\u002Fspan>\u003C\u002Fp>","🧬",{"key":69,"title":79,"html":80,"icon":81,"updatedAt":73},"Signs and Symptoms","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Early rectal cancer may cause no noticeable symptoms.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Possible signs and symptoms include rectal bleeding, changes in bowel habits, more frequent bowel movements, a feeling of incomplete evacuation, narrowing of the stool, mucus in the stool, abdominal pain or bloating, constipation or diarrhea, unexplained weight loss, fatigue, or anemia.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Rectal bleeding can sometimes be mistaken for hemorrhoids, but the cause cannot be determined reliably from the appearance of the blood alone. Persistent or recurrent bleeding should be medically evaluated.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">More advanced local disease may cause bowel obstruction, urinary symptoms, abnormal vaginal discharge, or pelvic and sacral pain.\u003C\u002Fspan>\u003C\u002Fp>","📋",{"key":69,"title":83,"html":84,"icon":85,"updatedAt":73},"Diagnosis","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Diagnosis typically includes endoscopy, tissue biopsy, and imaging for staging.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Colonoscopy is an important diagnostic test because it allows direct examination of the rectum and the rest of the colon and enables biopsy of suspicious lesions.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">After diagnosis, pelvic MRI is one of the key tests for local staging. It helps assess the depth of tumor invasion, mesorectal lymph nodes, the mesorectal fascia, and nearby pelvic structures.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">CT of the chest, abdomen, and pelvis is commonly used to evaluate distant spread, particularly to the liver and lungs.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Endorectal ultrasound may be useful for selected very early tumors.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">PET\u002FCT is not routinely required for every newly diagnosed patient and is generally reserved for selected situations.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">CEA can support follow-up and treatment monitoring but cannot diagnose rectal cancer by itself.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Testing for mismatch repair deficiency or microsatellite instability is also important because it can affect hereditary cancer evaluation and treatment decisions.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 16px;\">\u003Cstrong>Staging and Local Risk Assessment\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 16px;\">\u003Cstrong>\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0px;\">\u003Cspan style=\"font-size: 15px;\">Rectal cancer is primarily staged using the AJCC TNM system.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0px;\">\u003Cspan style=\"font-size: 15px;\">T describes the depth and local extent of the primary tumor, N describes regional lymph node involvement, and M indicates distant metastases.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0px;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0px;\">\u003Cspan style=\"font-size: 15px;\">However, stage alone does not fully determine treatment. Pelvic MRI findings such as mesorectal fascia involvement, extramural vascular invasion, tumor height, and lymph node characteristics can also influence the treatment strategy.\u003C\u002Fspan>\u003C\u002Fp>","🩺",{"key":69,"title":87,"html":88,"icon":89,"updatedAt":73},"Treatment","\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"background-color: rgb(255, 255, 255); color: rgb(15, 17, 21); font-size: 15px;\">Treatment for rectal cancer should be jointly developed by a multidisciplinary team including colorectal surgery, medical oncology, radiation oncology, radiology, and pathology, based on tumor stage, location, high-risk factors on pelvic MRI, MMR\u002FMSI status, and the patient’s overall condition.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"background-color: rgb(255, 255, 255); color: rgb(15, 17, 21); font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"background-color: rgb(255, 255, 255); color: rgb(15, 17, 21); font-size: 15px;\">Modern rectal cancer treatment is no longer simply “chemoradiotherapy first, then surgery, then chemotherapy.” The treatment sequence can differ markedly among patients with different risk profiles.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"color: rgb(15, 17, 21); background-color: rgb(255, 255, 255); font-size: 16px;\">\u003Cstrong>Early Rectal Cancer\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Selected very early rectal cancers with favorable features may be treated with local excision rather than radical rectal surgery.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Local procedures can be performed through the anus and may preserve rectal and sphincter function.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cbr\u002F>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Because local excision does not remove regional lymph nodes, careful patient selection is essential. Additional treatment may be recommended if pathology reveals higher-risk features.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"color: rgb(15, 17, 21);  background-color: rgb(255, 255, 255);\">\u003Cstrong>\u003Cspan class=\"\">Locally Advanced Rectal Cancer (LARC) and Total Neoadjuvant Therapy (TNT)\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"color: rgb(15, 17, 21);  background-color: rgb(255, 255, 255);\">\u003Cstrong>\u003Cspan class=\"\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">For many patients with stage II or III rectal cancer or other high-risk local features, total neoadjuvant therapy (TNT) is now an important treatment strategy.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">TNT delivers chemotherapy and radiation-based treatment before surgery rather than splitting systemic therapy between the preoperative and postoperative periods.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Treatment may involve chemotherapy followed by chemoradiation or chemoradiation followed by consolidation chemotherapy.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">After treatment, the tumor is reassessed and surgery—typically total mesorectal excision—is considered.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">NCI currently describes TNT as a preferred approach for most patients with locally advanced, nonmetastatic rectal cancer.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cstrong>Total mesorectal excision (TME)\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Total mesorectal excision (TME) is a fundamental surgical principle for many mid- and low-rectal cancers.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">The operation depends on tumor location, sphincter involvement, surrounding structures, and functional considerations.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Low anterior resection or other sphincter-preserving procedures may be possible when adequate cancer margins can be achieved while preserving useful sphincter function.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">If the sphincter is involved or adequate margins cannot be achieved safely, abdominoperineal resection with a permanent colostomy may be necessary.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">A fixed distance from the anal sphincter does not by itself determine whether sphincter preservation is possible.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cstrong>Immunotherapy for dMMR\u002FMSI-H Rectal Cancer\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>\u003Cstrong>\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Immunotherapy is one of the most important recent developments in rectal cancer treatment.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">A minority of rectal adenocarcinomas are mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H). These tumors can be particularly sensitive to PD-1 checkpoint inhibition.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">In locally advanced dMMR rectal cancer, studies of neoadjuvant dostarlimab have shown striking clinical complete responses, allowing some patients to avoid chemoradiation and surgery.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">This field is evolving rapidly, and decisions about immunotherapy alone or omission of surgery should be made by experienced multidisciplinary teams according to current evidence and local approvals.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cstrong>Metastatic Rectal Cancer\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>\u003Cstrong>\u003Cbr\u002F>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Metastatic rectal cancer is not treated with chemotherapy alone in every case.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">The first question is whether distant metastases—particularly in the liver or lungs—can be completely removed or potentially converted to resectability after systemic treatment.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">Selected patients with limited resectable metastases may still receive treatment with curative intent, including surgery or local ablation together with systemic therapy.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 7px 0;\">\u003Cspan style=\"font-size: 15px;\">For unresectable metastatic disease, systemic therapy is the main approach. Treatment may include fluoropyrimidine-based chemotherapy combined with oxaliplatin or irinotecan and targeted or immune therapies selected according to biomarkers such as RAS, BRAF, HER2, and MMR\u002FMSI status.\u003C\u002Fspan>\u003C\u002Fp>","💊",{"author":69,"reviewedBy":69,"lastReviewed":69,"datePublished":69,"citations":91,"disclaimer":69},[],false,1792294354698]