Local treatment of rectal cancer

Local treatment with transanal tumour excision has shown to be associated with signifi cantly decreased morbidity and mortality compared to conventional surgery (laparoscopic or open). Local treatment should be considered in select patients with early cancer or in patients with signifi - cant co-morbidity and in the very elderly patients with less oncological control as a compromise. Patient selection is important and highly dependent upon a multidisciplinary approach. The most important factors are correct preoperative staging and perioperative radiochemotherapy to minimize the risk of local recurrence. The role of local treatment in palliation of advanced disease is unknown.