How do you decide on the timing of neoadjuvant chemoRT or short course radiation for a patient with mid-upper rectal cancer with resectable liver only metastases?   

Upfront multiD discussion is really essential for a case like this as I do think we need to be selective of ideal candidates. If the group consensus is to proceed along a pathway involving “curative intent” local therapies, I do favor starting with systemic therapy to establish disease b...

There are compelling long-term outcomes from Bisschop et al with the Dutch 'M1' study supporting a rationale of short course radiation therapy followed by systemic therapy and curative surgery. This study followed all 50 patients in this multi-institutional phase II study; and found a median ov...

These are potentially curable cases and therefore it's important to cure the pelvis. The extent of the pelvic disease impacts how I would time the RT and surgery. If the disease in the pelvis comes close to or involves the mesorectal fascia, I would not recommend chemotherapy followed by short cours...