Combined multimodality treatments, including radiation, chemotherapy, and total mesorectal excision have been studied extensively over the past few decades, with efforts toward improving rates of locoregional recurrence and disease-free and overall survival in rectal cancer. Predictive and prognostic markers to adjuvant systemic chemotherapy have been identifi ed, with the goal of tailoring therapy and continuing improvement in survival. In our article, we discuss these factors, including tumor downstaging, pathologic node status, gene expression, and future directions in therapy of rectal cancer.
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