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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2005 October;18(5):241-54
Cancer of the rectum: complementary treatment versus surgery. Individuation of clinical-organisational Guidelines
Genovese A. M.
Carcinoma of the rectum is the second cause of tumour-related death in both men and women. In Italy the frequency of new cancers of the colon-rectum is 30-53 new cases annually per 100,000 inhabitants, and 1/3 of these are cancer of the rectum only. At present in Italy no standardized information has been published regarding treatment procedures for cancer of the rectum, and this represents a serious gap, both in terms of evaluating the appropriateness and quality of the care given, and for the possible planning of research protocols at a national level. Although the various centres have arrived at a more or less standard procedure from the point of view of diagnostics, the difficulties involved in deciding on the strategy for aggression are a result of the lack, until now, of a clear, standardised treatment protocol that is recognised and unanimously accepted by the international scientific community. There is, by now, no doubt that the best curative chances are offered by an integrated, multidisciplinary therapeutic approach in which radiotherapy and chemotherapy work together with the surgical treatment for the systematic, local eradication of the illness, but it is not yet known what the best and most effective therapy system is. The result of this is the need to move from a purely surgical approach towards a multidisciplinary approach with the aim of arriving at an integrated protocol for rectal neoplasia treatment which is in keeping with current knowledge. In this study the Authors, based on their own experience and on data obtained from the literature, will attempt to comprehensively tackle all of the problems which are as yet unresolved, to define the current state of the art and, finally, to outline an integrated protocol for rectal neoplasia treatment which is in keeping with current knowledge.