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Invited Commentary
August 15, 2018

Locally Advanced Rectal Cancer: Is It Time for a Paradigm Change?

Author Affiliations
  • 1Department of Surgery, University of North Carolina, Chapel Hill, Chapel Hill
JAMA Surg. 2018;153(8):e181620. doi:10.1001/jamasurg.2018.1620

The modern era of rectal cancer surgery started with the introduction of the concept of total mesorectal excision (TME) by Heald and Ryall.1 They reported an overall survival rate of 87% in patients who underwent a resection for a cure. The rationale behind TME has been further validated by the understanding of the importance of the circumferential resection margins and the quality of TME, both prognostic markers of recurrence and survival.2,3 To further improve these results, the use of neoadjuvant chemoradiation therapy has become the standard of care for stage 2 to 3 rectal cancer.4

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