Abstract:

CACA guidelines for holistic integrative management of rectal cancer （2024 Edition）fully refers to the latest researches at home and abroad， integrates experts' opinions in relevant fields and forms an updated version.In the epidemiology section， according to the latest data of the National Cancer Center， the detailed data of incidence and mortality of colorectal cancer were updated.In the screening section， the beginning age for general population screening has changed to 45 years old.In the surgical section， novel evidences have been added to total mesocolectomy， natural orifice specimen extraction surgery， “robotic” surgery and transanal total mesorectal excision.In the internal medicine section， novel evidences have been added to immunotherapy， and it is recommended that patients with dMMR/MSI-H status can consider immunotherapy.Besides， based on the latest researches， the chemotherapy cycles for high-risk stage Ⅱ patients and low-risk stage Ⅲ patients have been updated.In the radiotherapy section， the principles of preoperative neoadjuvant chemoradio-therapy were refined and reset， and different plans were developed based on tumor staging， microsatellite status and anal preservation intention.The principles of combined chemoradiotherapy for rectal cancer and the opportunity of surgery after chemoradiotherapy were also updated.In the traditional Chinese medicine section， the principle of “treatment based on syndrome differentiation” has been changed to “the combination of treatment based on disease differentiation and treatment based on syndrome differentiation”.At last， the current edition have added “treatment based on syndrome differentiation during rectal cancer follow-up period” section and the application of nonpharmacological therapies in traditional Chinese medicine.

Key words: Rectal neoplasms, Guidelines, Surgical treatment, Internal medicine treatment, Radiotherapy, Traditional Chinese medicine treatment