This book explores the surgical and therapeutic challenges posed by locally advanced rectal cancers located below the anterior peritoneal reflection-a region historically associated with high relapse rates. It examines modern treatment standards, specifically preoperative chemoradiotherapy (CRT) with fluoropyrimidine, as recommended by the European Society for Medical Oncology (ESMO) guidelines. The text further evaluates phase II trials involving combination therapies with oxaliplatin or irinotecan, balancing enhanced tumor regression against increased toxicity profiles. By analyzing tumor downstaging, sphincter preservation, and overall survival rates, this book provides a comprehensive evaluation of clinical outcomes and the long-term impact on patient quality of life.
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