Neoadjuvant Therapy for Rectal Cancer

CASE SUMMARY: A 63-year-old man presents to his primary care doctor with a 1-month history of blood in his stools. He is referred for a colonoscopy and found to have a friable mass along the anterior wall just proximal to the second rectal fold. A biopsy confirms moderately differentiated adenocarcinoma. The patient then obtains pelvic MRI and chest, abdomen, and pelvis CT demonstrating local invasion of the primary tumor into the mesorectal fat (T3), no suspicious regional lymph nodes (N0), and no evidence of distant metastatic disease (M0).