Multidisciplinary approach in staging and the choice of treatment in rectal cancer patients
Opportunities for improving the results of treatment of patients with colorectal cancer are in the plane of the universal introduction and standardization of a multidisciplinary approach. Currently, 5-year survival of patients with tumors of this localization varies from 30% in developing countries to 66% in developed countries. It seems to us that such a significant difference in the results of treatment of patients with rectal cancer is caused by the presence or absence of a multidisciplinary treatment program. Fundamental to the creation of a multidisciplinary approach in the treatment of rectal cancer were studies Heald R.J., Quirke P. and Brown G. Heald R.J. showed that a sharp separation and removal of mesorectal tissue within their own fascia (total mezorektumektomiya) most closely corresponds to the principles of oncological radicalism. Based on work Quirke P. it was found that the ratio of tumor to own fascia of the rectum is the main predictor of the development of local-regional recurrence, as well as a classification of the quality of operations performed. Direct dependence of the results on the quality of treatment of total mezorektumektomiya (TME) was evident after the studies that have demonstrated a significant increase in relapse-free period in the TME grade 3 according to the criteria Quirke [50]. Through the work of Brown G. it has been found that it is magnetic resonance imaging allows the most accurate visualization of its own fascia of the rectum and predict the circular border resection.