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Article
June 1993

Cancer of the RectumWhere Are We? Where Are We Going?

Author Affiliations

Claude E. Welch, MD, is emeritus clinical professor of surgery at the Harvard University School of Medicine and the Massachusetts General Hospital, Boston. He is formerly president of the American College of Surgeons and the American Surgical Association.; John P. Welch, MD, a 1968 graduate of the Harvard Medical School, is clinical professor of surgery at the University of Connecticut Health Center, Farmington, and the Hartford (Conn) Hospital.

Arch Surg. 1993;128(6):697-702. doi:10.1001/archsurg.1993.01420180099018
Abstract

IN certain families, both the father and a son are surgeons. The editor of the Archives has invited several such pairs to contribute to his journal. We have chosen a topic that has attracted a great deal of attention during our professional lives, namely, treatment of cancer of the rectum.

We first shall outline our current approach to the treatment of this disease and follow with other comments on two particularly important aspects: the current role of adjuvant treatment in addition to surgery and an evaluation of anal sphincter—saving procedures. Our opinions reflect continuing studies in the Hartford (Conn) Hospital and the Massachusetts General Hospital (MGH), Boston.

What are the goals of therapy insofar as individual patients with rectal cancer are concerned? The first is cure of the cancer by elimination of the primary tumor and metastases. Second, complications due to the particular type of therapy should be minimal. A

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