Kolorektale Karzinome (KRK) sind die häufigsten Malignome des Gastrointestinaltraktes in der westlichen Welt. Knapp 40 % dieser Tumoren entfallen dabei auf das Rektum. In den letzten Jahren ist es insbesondere durch multimodale Therapiekonzepte zu einem deutlichen Wandel in der Behandlung des Rektumkarzinoms gekommen. Daneben hat sich die totale mesorektale Exzision (TME) als chirurgisches Standardvorgehen mehr und mehr durchgesetzt. Durch die Kombination der multimodalen Therapiekonzepte mit einer optimierten Chirurgie konnten wesentliche Primärziele der Behandlung des Rektumkarzinoms wie eine hohe R0-Resektionsrate, eine geringe Lokalrezidivrate und der Erhalt des Schließmuskels deutlich häufiger erreicht werden. Trotz dieser Verbesserungen sind die Ergebnisse, bezogen auf die Fernmetastasierungsrate, nach wie vor unbefriedigend, und aktuelle Studienkonzepte versuchen, hier durch eine Optimierung der systemischen Chemotherapie die Verbesserung der Therapieergebnisse des Rektumkarzinoms voranzutreiben.
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