Current and Future Perspectives of Rectal Cancer Management


Bunchorn Siripongpreeda, MD

Department of surgery, Chulabhorn Royal Academy, Bangkok, Thailand


Colorectal cancer was one of the five most common cancers found in many countries included Thailand, and it also was leading cause of cancer deaths for years. Accumulating knowledge in carcinogenesis of this cancer afforded progression in management to control disease. There were several modalities for detection of known steps in carcinogenesis. Each screening modality had more benefit than others by its character and aspect.  If approach in precancerous stage with further additional proper management such as colonoscopy with polyp removal had been done, this would prevent formation of new colorectal cancer case. Detection of earlier staged cancer added more survival benefit to patients. Some developed countries with high disease incidence applied some interventions for colorectal cancer screening as national policy and seemed to success in decrease incidence and mortality of this disease. So colorectal cancer appeared to be one of the preventable cancers in health care management. Unfortunately, the intervention with high yield that needed to be handled for control colorectal cancer was invasive, resumed numerous resource and skills. Many people refused the offered uncomfortable and fearfully presumed intervention and more were inaccessible status or unaffordable health service, the incidence of this disease continued showing increment or not obvious decrease in many countries. Challenges in development of better screening method and strategy for colorectal cancer control were gradually invaded by flood of multidisciplinary related data.


Keeratikarn Boonyawan, MD

Department of Therapeutic and Diagnostic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand


The management of rectal cancer has been changed continually either surgery or concurrent chemoradiation (CCRT). According to the phase III randomized control trial from Germany1 demonstrated the superior outcomes of pre-operative CCRT including local control, sphincter preservation and toxicity when compared with post-operative CCRT.  Pre-operative CCRT is the standard treatment of patients with stage II and III rectal cancer; however, the benefit of pre-operative CCRT for those patients who has favourable features such as T1-2N1, T3N0 and upper rectal cancer remains controversial. Moreover, many unclear issues needed further investigation such as the use of chemotherapy, role of surgery for patients who achieve pathological complete response and the use of particle beam.


1. Sauer R, Liersch T, Merkel S, Fietkau R, Hohenberger W, Hess C, et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Cli Oncol .2012;30(16):1926-33.

Event Hours(1)

  • Lotus 3-4

    01:00 pm – 02:15 pm

    1. Assoc. Prof. Atthaphorn Trakarnsanga (SI)
    2. Dr. Bunchorn Siripongpreeda (CRA)
    3. Dr. Keeratikarn Boonyawan (Rama)
    4. Asst. Prof. Surbpong Tanasanvimon (CU)

    Asst. Prof. Charuwan Akewanlop (SI)