Rectal cancer clinical practice guidelines in oncology

Paul F. Engstrom, Al B. Benson, Yi Jen Chen, Michael A. Choti, Raza A. Dilawari, Charles A. Enke, Marwan G. Fakih, Charles Fuchs, Krystyna Kiel, James A. Knol, Lucille A. Leong, Kirk A. Ludwig, Edward W. Martin, Sujata Rao, M. Wasif Saif, Leonard Saltz, John M. Skibber, Alan P. Venook, Timothy J. Yeatman

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


The NCCN Rectal Cancer Guidelines panel believes that a multidisciplinary approach is necessary for treating patients with colorectal cancer. Patients with T1 or T2 lesions that are node-negative by endorectal ultrasound and who meet carefully defined criteria can be treated with a transanal excision. Abdominal peritoneal resection or low anterior resection with total mesorectal excision is appropriate for all other rectal lesions. Either preoperative chemoradiation or postoperative chemoradiotherapy is standard for patients with suspected or proven serosal invasion (pT3) or regional node involvement. Patients with recurrent localized disease should be considered for resection with or without radiotherapy. Chemotherapy regimens using irinotecan or oxaliplatin should be considered for patients with distant metastasis. The panel endorses the concept that treating patients in a clinical trial has priority over standard or accepted therapy.

Original languageEnglish (US)
Pages (from-to)492-508
Number of pages17
JournalJNCCN Journal of the National Comprehensive Cancer Network
Issue number4
StatePublished - Jul 2005
Externally publishedYes


  • Adjuvant chemotherapy
  • Adjuvant radiotherapy
  • Colorectal surgery
  • Fluorouracil
  • Irinotecan
  • NCCN clinical practice guidelines
  • Neoplasm recurrence
  • Neoplasm staging
  • Oxaliplatin
  • Rectal neoplasms

ASJC Scopus subject areas

  • Oncology


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