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LCC REC-1
Φ
π
π
π
Φ
Φ
See Primary and Adjuvant Treatment (LCC REC-3)
See Primary and Adjuvant Treatment (LCC REC-3)
Observe or See Primary Treatment (LCC REC-3)
Rectal Cancer
LCC REC-2
See Primary Treatment (LCC REC-3)
See Primary Treatment (LCC REC-4)
See Primary Treatment (LCC REC-4)
See Primary Treatment (LCC REC-5)
See Primary Treatment (LCC REC-6)
Rectal Cancer
LCC REC-3
Chemoradiotherapy
Chemoradiotherapy
Surveillance (See LCC REC-7)
High risk features include positive margins, lymphovascular invasion and poorly differentiated tumors.
Φ
Φ
Rectal Cancer
LCC REC-4
Surveillance (See LCC REC-7)
Preoperative chemoradiation
(Neoadjuvant Chemoradiotherapy)
Chemotherapy
Reconsider adjuvant Chemoradiotherapy
Chemoradiotherapy Chemotherapy
Φ
Φ
π
π
Rectal Cancer
LCC REC-5
Surveillance (See LCC REC-7)
Chemoradiotherapy
Chemotherapy
Chemotherapy
Chemoradiotherapy
Chemoradiotherapy
Chemoradiotherapy
Φ
Φ
Rectal Cancer
LCC REC-6
Chemotherapy
Chemoradiotherapy
or
Resection of involved rectal segment
or
Diverting colostomy
or
Chemotherapy alone
Rectal Cancer
LCC REC-7
See Workup and Treatment (LCC REC-8)
If patient is a potential candidate for resection of isolated metastasis.
High risk for recurrence (eg, lymphatic or venous invasion by tumor, or poorly differentiated tumors).
Villous polyp, polyp > 1 cm, or high grade dysplasia.
Φπ
†
Φ
π
†
Rectal Cancer
LCC REC-8
Reevaluate chest/abdominal/pelvic CT in 3-6 months
See treatment for Documented metachronous metastases (LCC COL-8)
See treatment for Documented metachronous metastases (LCC REC-9)See treatment for
Documented metachronous metastases (LCC REC-9)
See treatment for Documented metachronous metastases (LCC REC-9)
Preoperative chemoradiotherapy Resection, if feasible
Radiation, if not given previously.
Φ
Φ
Rectal Cancer
LCC REC-9
See Primary Treatment (LCC REC-10)
Chemotherapy
πTherapy may be considered for a maximum of 6 months.
π
π
Rectal Cancer
LCC REC-10
Chemotherapy
Chemotherapy
π
π
π
π
πTherapy may be considered for a maximum of 6 months.
Rectal Cancer
Recommended