Resumen
Treatment of locally advanced rectal cancer has been subject to pronounced changes based on the results of recent prospective trials. New paradigms have been introduced, including the shift of systemic treatment components from adjuvant to neoadjuvant setting (total neoadjuvant therapy), the omission of surgery in patients with clinical complete responses after neoadjuvant treatment (non-operative management) and the introduction of upfront immunotherapy in patients with microsatellite instability (MSI)-high/mismatch-repair-deficient (dMMR) tumors. We developed an institutional treatment algorithm which may serve as a practical tool for treating physicians without any claim to general validity.