The cure rate for nonmetastatic rectal cancer has been improving for decades. Treatment for stage II and III rectal adenocarcinomas now routinely includes surgery, radiation therapy, and chemotherapy. The results of recent phase 3 trials have led to an increase in the intensity of treatment to include multiagent chemotherapy in addition to radiation therapy before proctectomy is performed; such treatment has resulted in a 3-year disease-free survival rate as high as 77%.1,2 Unfortunately, this treatment approach is grueling and can cause substantial long-term sequelae, including neuropathy, infertility, and bowel and sexual dysfunction. However, this more aggressive preoperative treatment also opens . . .
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This editorial was published on June 5, 2022, at NEJM.org.
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