Thirty years of rectal cancer research: a brief history.

Prior to the mid-1980s, patients with rectal cancer usually underwent surgery alone, resulting in high rates of pelvic failure with subsequent morbidity and death. Trials from the 1980s to 1990s showed that postoperative chemoradiotherapy decreased pelvic failure rates and improved survival, leading to its incorporation into the routine management of patients with resected stage II/III disease.[1,2] A growing European surgical experience showed that total mesorectal excision (TME) alone resulted in high rates of local control, demonstrating the importance of surgical technique in reducing pelvic failure and raising the question of the need for radiation therapy.[3]