Most colorectal cancers develop from polyps (adenoma-carcinoma sequence). However, other tumours may develop when dysplasia in the mucosa arises, such as in long-standing ulcerative colitis, Crohn's disease, flat adenomatous disease and perhaps in some cases of hereditary non-polyposis colorectal cancer (HNPCC) patients (dysplasia-carcinoma sequence). In praxis, stage and grading of the tumour itself as well as mobility, size and level of the rectal cancer are facts that must be accepted by the surgeon, and they all influence outcome. Newer studies with a multimodal concept including neoadjuvant therapy seem to be promising [13,14].
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