New directions in the preoperative management of adenocarcinoma of the rectum.

Pathological complete response is observed in nearly 20% of patients with rectal cancer receiving preoperative chemoradiation. Patients who achieve a pathological complete response have better outcomes compared to patients experiencing no response or partial response. Current strategies have not demonstrated a substantial improvement in augmenting the ratio of responders to partial and nonresponders. The following discussion addresses possible strategies of investigation to increase patients achieving a complete obliteration of rectal tumors following neoadjuvant chemoradio therapies.