ABSTRACT
Locally advanced rectal cancers (LARCs) and locally recurrent rectal cancers (LRRCs) are challenging cancers to manage. The reported incidence of LARC ranges between 10% and 25% depending on definition of LARC. The incidence of LRRC in the era of total mesorectal excision ranges from 5% and 15%, which is a vast improvement from the local recurrence rate of over 30%. Patients with LARC usually present similarly to other primary rectal cancers. Symptoms may include rectal bleeding, altered bowel habits or tenesmus. The gold-standard diagnosis of both LARC and LRRC remains histological diagnosis. As with any rectal cancer, obtaining tissue for histology in patients with LARC is usually relatively straightforward. In patients with LRRC however, histological diagnosis may be difficult depending on the site of recurrence and whether or not the patient has had a sphincter-saving procedure.
