Total mesorectal excision (TME) remains the gold standard for rectal cancer because it provides superior oncologic outcomes compared with local excision (LE). LE can be offered as an alternative for carefully selected patients; however, it must be emphasized that even in ideal patients, LE does not achieve equivalent results regarding oncologic outcomes compared with TME. With LE, patients trade a higher cancer cure rate for a lower risk of mortality and lower morbidity. The role of chemoradiation and LE in the treatment of rectal cancer is still under study.
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