Rectal cancer treatment constitutes a complex exercise. With the exception of very early and metastatic disease were surgery and palliative chemotherapy are respectively the backbone treatment modalities, the optimal treatment strategy for rectal cancer remains a subject of active debate. Different therapeutic options, including local and systemic approaches like different surgical techniques, radiation therapy, chemoradiotherapy and chemotherapy in different sequences and settings are commonly combined in clinical practice. This multimodal treatment strategy improved survival and reduced local recurrence, but the optimal way to combine the different modalities represents a subject of active research. In the coming paragraphs we attempt to answer some of the most important questions, in our opinion, regarding multimodality treatment approach for rectal cancer through a systematic review of the literature.

(BELG J MED ONCOL 2020;14(7):311-20)