Multimodality Treatment for Locally Advanced and Recurrent Rectal Cancer

Colorectal cancer is a major problem in the western world and has a rising incidence.1,2 Approximately one third of these tumours originate in the rectum. Although colon and rectal cancer share similar features there is a distinct difference in clinical behaviour and therapeutical approach.3 The treatment of primary rectal cancer has evolved into a multidisciplinary treatment with standardized surgical, pathological and radiotherapeutical procedures.2,4-6 The introduction of preoperative short-term radiotherapy (5*5Gy) in combination with total mesorectal excision (TME) has lead to a signifi cant decreased local recurrence rate.7 Based on these benefi cial results the treatment protocol in the region of the Comprehensive Cancer Centre Rotterdam of patients with a tumour in the lower two-third of the rectum was changed.2 In chapter 2 we report the results of a registration study in the region of the Comprehensive Cancer Centre Rotterdam. The aim of this study was to identify the compliance to a new standardized treatment protocol i.e. the introduction of preoperative radiotherapy. Furthermore, the results of rectal cancer treatment in the Rotterdam region were analyzed and compared with reference values based on selected patients from randomised trials in the recent literature.

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