- Nonoperative management of rectal cancer aims to maintain excellent tumor control while avoiding the morbidity of radical surgery.
- The clinical response to upfront chemoradiation is utilized to select patients who are most appropriate for nonoperative management.
- Retrospective and limited prospective evidence suggests that nonoperative management results in high rates of local control and diseasefree survival compared with historical rates from combined-modality therapy. This is being explored in prospective registry and randomized studies.
- Combined-modality therapy remains the standard of care for locally advanced rectal cancer. Nonoperative management should not be offered outside of clinical trials.