Rectal Cancer: New Insights into the Diagnosis and Treatment

Dear Colleagues,

Rectal cancer has been a driving challenge for basic science (carcinogenesis, molecular biology, pharmacology) and clinical medicine, such as pathology, gastroenterology, radiology, surgery oncology and medical/interdisciplinary oncology. Only a few years ago, surgery had been the mainstay of treatment at all stages, and was significantly improved by, e.g., Richard Heald and Takeo Mori, to reduce the initially high local relapse rates. Diagnoses are performed via endoscopy + endoscopic ultrasound, histology and a CT scan/abdominal ultrasound/X-ray of the lungs. At this time, the treatment strategy of another cancer type located at the exit of the rectum, anal cancer, had been changed by N. D. Nigro from extensive surgery to radiochemotherapy, avoiding abdominoperineal resection. Despite being refused by “older” surgeons, the multimodal treatment or conservative therapy of defined stages in rectal cancer has  now become standard and is continously improving. Radiochemotherapy in the adjuvant or neoadjuvant set up, together with systemic chemotherapy, is now included in national S3 guidelines. Neoadjuvant radiochemotherapy at stages UICC II+III and in T4 primary tumor stages are mostly preferred as the standard. New developments are aiming at individualizing treatment to radiochemotherapy without resection in patients at a high risk for surgery. New methods in magnetic resonance tomograpy (MRT) help make individual decisions, including the „Japanese“ lateral lymphnode dissection in case of radiologically suspect lateral lymph nodes. The outcome in rectal cancer treatment varies with surgical quality and the quality of interdisciplinary multimodal diagnosis and treatment, molecular biology included. In this context, continous developments contribute to individualized concepts and highest quality at specialized centers.

This Special Issue on rectal cancer provides new insights into the diagnosis and treatment of this cancer type, frequent in Western countries and increasing in incidence in Eastern countries. 

Prof. Dr. Karl Heinrich Link
Guest Editor

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• rectal cancer
• tumor biology/molecular profiling
• MRT/CT/endoscopic diagnosis
• multimodal therapy
• robotic surgery
• surgical quality
• treatment individualization
• conservative treatment
• radiotherapy/radiochemotherapy