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What is A 60 years old male presented to OPD with bleeding PR. On DRE, growth was felt at by the tip of index finger. On sigmoidoscopy, there was an ulcero-proliferative growth located 6 cm from anal verge. On CECT, liver and lungs were not involved. After chemoradiation, what is the next best step? and explain in detail?
Ca. rectum - Length of surgical anal canal - 3 cm - Growth on DRE - (10 cm) - In rectum - Growth Located >5 cm above anal verge - LAR - Growth located at Anorectal junction or <5 cms from anal verge - APR Stage I - Surgical excision Stage II Stage III Stage IV Neo adjuvant chemoradiation + Surgical excision