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Clin Colon Rectal Surg 2016; 29(02): 106-113
DOI: 10.1055/s-0036-1580722
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surgery for Locally Advanced T4 Rectal Cancer: Strategies and Techniques

Authors

  • Ramzi M. Helewa

    1   Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada

  • Jason Park

    2   Section of Surgical Oncology, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
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Publikationsdatum:
26. Mai 2016 (online)

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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