Available online 7 June 2022, 100900

Local excision (LE) for early-stage rectal cancer is an attractive option compared to total mesorectal excision (TME), as it avoids many of the significant comorbidities and adverse functional outcomes associated with TME. However, LE for tumors with high-risk histopathologic features can lead to unacceptably high rates of local and distant recurrence. Neoadjuvant or adjuvant chemoradiotherapy can mitigate those risks in certain clinical settings and may expand the number of patients who can be safely treated with an organ-preserving approach. In this chapter, we will explore the available date supporting the use of neoadjuvant and adjuvant CRT for the treatment of high-risk early-stage rectal cancer and will discuss future studies that aim to answer some of the ongoing clinical questions related to this practice.

Rectal cancer

Neoadjuvant chemoradiotherapy

Local excision

Organ preservation

Total mesorectal excision

© 2022 Published by Elsevier Inc.