Challenges in determining the benefits of restaging after chemoradiotherapy for locally advanced rectal cancer

摘要

Primary staging: Primary staging in rectal cancer is essential for determining the optimal treatment strategy and consists of local staging and screening for distant metastases. Local staging is important to determine the surgical approach and to identify individual risk factors for recurrence, such as depth of extramural spread, lymph node involvement, mesorectal fascia (MRF) involvement and extramural vascular invasion [1-4]. Patients with a low risk for recurrence can be treated by surgery alone, whereas patients with a high risk for recurrence must be treated with neoadjuvant (chemo-) radio-therapy (CTxRTx) to decrease the chance of local recurrence [5,6].