Colorectal Pathology in the Pelvis

Abstract

Objective:

Management of rectal cancer has undergone major shifts in the past few decades and continues to evolve. With radical surgical resection historically being the primary means of treatment, there has been a shift of paradigm toward less-morbid therapeutic approaches. These approaches utilize novel advancements in multidisciplinary therapy, such as chemotherapy and radiation therapy, to the benefit of the patient, thus leading to a better quality of life (QoL), decreased operative and wound complications, and an increased rate of sphincter preservation, while maintaining high-quality oncologic principles. The main objective of this literature review is to discuss the latest data and available guidelines for multidisciplinary management of rectal cancer.

Materials and Methods:

This discussion includes the newest clinical trials regarding total neoadjuvant treatment and watch-and-wait management. In addition, special note is given to complications and sequelae that rectal pathology and its treatment can have on female pelvic organs, thus presenting diagnostic and technical challenges.

Conclusions:

With more clinical trials attempting to change the management of rectal cancer toward more patient-friendly treatment modalities, further research is required to establish and finalize guidelines to improve patient outcomes and QoL, while simultaneously dealing adequately with the primary malignant pathology.