Rectal Cancer

Symposium - Vic Verwaal at ESCP Sorrento 2010

New trials forum - Alexandra Coxon-Meggy (United Kingdom) at ESCP Vilnius 2023

One of the Six Best Papers - Jérémie Lefevre at ESCP Sorrento 2010

Oral Poster (Neoplasia) - Ingvar Sverrisson at ESCP Dublin 2015

Oral poster - David Pettersson at ESCP Vienna 2012

ESR Hughes Keynote Lecture - Cameron Platell (Australia) at Tripartite Colorectal Meeting 2014

One of the Six Best Papers - Ashish Sinha at ESCP Sorrento 2010

Short Paper - James Moore (Australia) at Tripartite Colorectal Meeting 2014

Oral Poster (Neoplasia) - Anders Elliot at ESCP Barcelona 2014

Educational session - Roel Hompes (The Netherlands) at ESCP Dublin 2022

Free Paper (Neoplasia) - Evgeni Rybakov at ESCP Dublin 2015

Oral poster - Therese Juul at ESCP Belgrade 2013

Japanese Visiting Fellow - Kenji Matsuda at ESCP Dublin 2015

ESCP/EAES joint symposium - Fred Ris (Swtizerland) at ESCP Vilnius 2023

Rectal cancer should be managed by a multidisciplinary team (MDT) that includes input from gastroenterology, radiology, pathology, radiation oncology, and oncology in addition to colorectal surgery. The workup of suspected rectal cancer includes digital rectal examination, rectoscopy (proctoscopy), and biopsy. Staging of the tumor requires thoracic/abdominal computed tomography, pelvic magnetic resonance imaging, and complete colonoscopy to assess local tumor growth, systemic spread, and synchronous colonic lesions. The findings should be discussed during an MDT conference to determine the optimal sequence of treatment and the timing and extent of surgical resection. Radiotherapy, which is best delivered preoperatively, reduces the risk of local recurrence and may enhance survival in high-risk patients. Concomitant chemotherapy is used to increase the effect of radiotherapy (chemosensitizing radiation). Complete resection of the rectum en bloc with the surrounding mesorectal envelope enclosing draining lymphatic tissue, called total mesorectal excision, is the gold standard to decrease the risk of local recurrence and avoid injury to adjacent pelvic structures. Rectal cancers in the middle and upper third of the rectum can be treated with sphincter-saving anterior resection and colorectal anastomosis. Cancer in the lower third of the rectum may be amenable to low anterior resection with coloanal anastomosis or require abdominoperineal excision. Tumors involving the pelvic floor or external anal sphincter are treated with extralevator abdominoperineal excision and permanent colostomy. Preoperative chemoradiotherapy may result in complete clinical and radiological response. Such patients may enter a watch-and-wait program of intensive surveillance to detect tumor regrowth. Review of the surgical specimen pathology during a postoperative MDT meeting is important to ensure treatment quality and to determine the potential need for adjuvant chemotherapy. Follow-up after treatment, to detect metachronous colorectal cancer, local recurrence, or systemic disease, should continue for 5 years. Surgery and radiotherapy have adverse effects on function of the bowel, urinary bladder, sexual organs, and gonads, which warrant attention both at the onset of treatment and during follow-up.

Keynote Lecture - Eric Rullier at ESCP Barcelona 2014

Scientific session - Brendan Moran (UK) at ESCP Dublin 2022

Scientific session - Konstantinos Stamou (Greece) at ESCP Dublin 2022

Scientific session - Seon Hahn Kim (South Korea) at ESCP Dublin 2022

Scientific session - Jim Khan (UK) at ESCP Dublin 2022

Free paper - Etienne Buscail at ESCP Belgrade 2013

Quentin Denost (France) at ESCP Vilnius 2023

Joep Knol (Belgium) at ESCP Vilnius 2023

Felix Aigner (Germany) at ESCP Vilnius 2023

Jim Khan (United Kingdom) at ESCP Vilnius 2023

Sharaf Perdawood (Denmark) at ESCP Vilnius 2023

Antonino Spinelli (Italy) at ESCP Vilnius 2023

Yusuke Kinugasa (Japan) at ESCP Vilnius 2023

Nuno Figueiredo (Portugal) at ESCP Vilnius 2023

Benjamin Fernandez at ESCP Vilnius 2023