الفهرس 
List of ContentsOnly 14 pages are availabe for public view
 |  | from | 179 |  |  |
| | | from | 179 | | |
Abstract
Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer. It is the second main cause of cancer related mortality. Locally advanced rectal cancer (LARC) can be defined as cancer invading adjacent structures, at a high probability of positive margin, positive nodal disease, and distally located tumors. Adoption of an optimal management strategy for LARC is a complex process. This is due to multiple factors. Firstly, the decision may be affected by goal of surgery (curative or palliative), functional results of surgical procedure selected, impact of treatment on patients’ quality of life, and primary tumor distance from anal verge (upper, mid or low rectum). Advances in rectal cancer management (ie, the selection of the total mesorectal excision as surgical technique, suitable timing and improved dosimetry of radiation therapy, and the addition of multidrug chemotherapy protocols) have led to a marked decrease in local recurrence rates-from as high as 25% to less than (5% to 10%) in LARC patients. Unfortunately, an evaluated 5-year distant relapse rate of 35% remains as one of the leading causes of death in those patients.