Rectal Cancer Treatment

The trial targets a 2-year organ preservation rate of 80% in cT1-3ab N0 early rectal cancer and 60% in cT1-3ab N1 early-intermediate rectal cancer. Moving chemotherapy into the neoadjuvant setting has improved tumor downstaging and allowed organ preservation in up to half of patients. Modern rectal cancer decisions require balancing oncologic benefit against functional harm. Rectal cancer treatment has traditionally involved multimodal therapy with surgery, radiation, and chemotherapy. Non-operative management emerged after complete responders to neoadjuvant treatment showed sustained disease-free survival. Primary organ preservation uses radiotherapy to achieve clinical complete response and avoid TME in patients who would not ordinarily receive neoadjuvant therapy. Pelvic surgery and radiation can cause long-term functional consequences affecting health-related quality of life.