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World J Gastroenterol. Feb 21, 2011; 17(7): 835-847
Published online Feb 21, 2011. doi: 10.3748/wjg.v17.i7.835
Management of stage IV rectal cancer: Palliative options
Gregory D Kennedy, Sean M Ronnekleiv-Kelly
Sean M Ronnekleiv-Kelly, Gregory D Kennedy, Department of Surgery, Section of Colon and Rectal Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, G4/701A CSC, Madison, WI 53792, United States
Author contributions: Ronnekleiv-Kelly SM and Kennedy GD wrote the manuscript.
Correspondence to: Gregory D Kennedy, MD, PhD, Department of Surgery, Section of Colon and Rectal Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, G4/701A CSC, Madison, WI 53792, United States. kennedyg@surgery.wisc.edu
Telephone: +1-608-2632521 Fax: +1-608-2637652
Received: August 30, 2010
Revised: January 4, 2011
Accepted: January 11, 2011
Published online: February 21, 2011
Abstract

Approximately 30% of patients with rectal cancer present with metastatic disease. Many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various complications that may afflict these patients. Endorectal stenting, laser ablation, and operative resection are a few of the options available to the patient with a malignant large bowel obstruction. A thorough understanding of treatment options will ensure the patient is offered the most effective therapy with the least amount of associated morbidity. In this review, we describe various options for palliation of symptoms in patients with metastatic rectal cancer. Additionally, we briefly discuss treatment for asymptomatic patients with metastatic disease.

Keywords: Palliative therapy; Rectal cancer; Malignant bleeding; Malignant obstruction; Endorectal stenting; Laser ablation