Rectal Cancer

[*]Despite advances in combined modality therapies, surgeons continue to play a pivotal role in the quality of oncologic and functional outcome of the rectal cancer patient. Whereas ten years ago tumor biology was perceived as the predominant determinant, recent experience has refocused our attention on quality of resection as a powerful predictor of local recurrence and overall results. It is now evident that although tumor-related factors will continue to play a formidable role in the natural history of rectal cancer, optimal surgical technique based upon sound appreciation of anatomic planes and patterns of rectal cancer spread will remain a pre-requisite for optimal overall results.

This issue of Clinics in Colon and Rectal Surgery is dedicated primarily to the multimodality management of rectal cancer. As evident from the titles of the chapters, the goal was to evaluate the state-of-the-art management of locally advanced rectal cancer, including aspects of preoperative staging, as well as specific intraoperative aspects of optimal pelvic surgery. The role of adjuvant radiation and chemotherapy are reviewed, as are the multimodality approaches to recurrent rectal cancer. The important role of the pathologist in assessing quality of rectal cancer surgery is discussed, as well as common tumors of the rectum, including lymphoma, neuroendocrine, and soft tissue tumors. Last, a quality of life assessment following rectal cancer resection is examined.

I would like to take this opportunity to acknowledge the outstanding contributions by my dedicated colleagues. I am grateful for their time and effort and am certain that the readership of Clinics in Colon and Rectal Surgery will find this issue dedicated to rectal cancer to be comprehensive, timely, and stimulating.