The significance of preoperative staging of rectal cancer and its effect to treatment strategy        WANG Hao，FU Chuan-gang．Department of Colorectal Surgery, Changhai Hospital, the Second Military Medical University，Shanghai 200433, China
Corresponding author：FU Chuan-gang，E-mail：fugang416@126.com
Abstract    Preoperative staging examinations are intended to identify the extent of rectal tumor infiltration accurately so as to select optimal individualized protocols for the sake of improving therapeutic outcomes. The two imaging modalities that are most useful for locoregional staging of rectal cancer are ERUS and pelvic MRI. Although they have their pros and cons, their accuracy for lymph node staging is unsatisfactory. Local excision or even endoscopic resection is a viable option for highly selective early-stage rectal cancer. Radical resection is preferred for more advanced rectal cancer that is not candidate for local excision. Preoperative chemoradiation is usually recommended for patients with locally advanced rectal cancer (T3-4 and/or N1-2 stage without distant metastasis). Neoadjuvant chemotherapy and surgical resection can be considered for patients with distal metastasis depending on individual conditions.