Colorectal Cancer OncoGuia.

The use of local excision to treat T2 and NX rectal cancers is highly controversial as lymph node metastasis can occur in up to 28% of cases (123). The treatment of choice in these cases is therefore total mesorectal excision (124). An alternative proposed by the NCCN (23) and classifi ed as a category 2B recommendation (lower-level evidence and nonuniform consensus) is the administration of chemoradiotherapy after local surgery. Nonetheless, it should be borne in mind that the effi cacy of this concomitant treatment regimen over total mesorectal excision in terms of local recurrence and survival needs to be demonstrated in clinical trials. [NCCN]