Defining preoperative treatment strategies in t3 rectal cancer.

Preoperative treatments for patients with T3 rectal cancer have significantly improved local recurrence rates, while survival outcomes have not changed significantly relative to those achieved with surgery alone. The prognosis of patients with T3 tumors, however, is heterogeneous; therapy should be carefully selected based on characteristics of the tumor and other prognostic indices to provide an optimal outcome for each patient. This paper summarizes key findings from several large trials that have examined use of preoperative radiotherapy and chemoradiotherapy for rectal cancer, how these results can be applied to selection of the best therapy for an individual patient, as well as prognostic/predictive factors that have been identified and clinical tools for measuring them.