Abstract
Locally advanced T4 rectal cancer represents a complex clinical condition that requires
a well thought-out treatment plan and expertise from multiple specialists. Paramount
in the management of patients with locally advanced rectal cancer are accurate preoperative
staging, appropriate application of neoadjuvant and adjuvant treatments, and, above
all, the provision of high-quality, complete surgical resection in potentially curable
cases. Despite the advanced nature of this disease, extended and multivisceral resections
with clear margins have been shown to result in good oncological outcomes and offer
patients a real chance of cure. In this article, we describe the assessment, classification,
and multimodality treatment of primary locally advanced T4 rectal cancer, with a focus
on surgical planning, approaches, and outcomes.
Keywords
rectal cancer - T4 - locally advanced - multimodality treatment - multivisceral resection
