Rectal cancer staging

Recommendations for the management of rectal cancer have been incredibly dynamic over the last several decades and accurate staging is required to make informed decisions and guide patient discussions. A complete staging evaluation should include a physical examination, complete colonoscopy, serum carcinoembryonic antigen level, and imaging to include a CT chest, MRI of the pelvis, and either a CT or MRI of the abdomen. Assessment of the circumferential resection margin with a rectal cancer protocol MRI is the cornerstone of this staging workup. Accurate staging is of paramount importance when considering treatment options for this complex disease.