Talking about colorectal cancer we must remember that although pathologically we consider adenocarci-noma of the colon and adenocarcinoma of the rectum as one disease, these two entities differ from each aspect: Anatomical differences in vascularisa-tion, lymphatic drainage and absence of a visceral layer beneath perineal reflection result in different risks of local recurrence after curative intent surgery. In 1974, the problem of local recurrence after low resection of the rectum was described by Gunderson. It was observed that tumours located beneath 12 cm from anal verge have a direct route of spreading in the pelvis via vessels, lymphatic system and directly via contact with surrounding tissues. With the introduction of TME, the rate of local failure dropped radically . Still, local recurrence is a major problem in rectal tumor surgery. Neoadjuvant and adjuvant radiotherapy (RT) were introduced to decrease the rate of local failure.
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