Surgery and radiotherapy for rectal cancer emerged in Europe at the dawn of the 20th century, marking the foundation of modern treatment strategies. Over the decades, Europe has led the way in conducting pivotal randomized trials, shaping and optimizing the multidisciplinary management of rectal cancer.

In 2018 ESCAT, a novel tool designed to enhance and standardize precision oncology, developed on the initiative of the ESMO Translational Research and Precision Medicine Working Group, has been presented. ESCAT employs data from massive sequencing (as next-generation sequencing analysis, NGS) to establish a hierarchy of genetic alterations in a tumor, thereby indicating those alterations that should be the primary focus of therapeutic action.

Interventional Oncology is a subspecialty of Interventional Radiology focused on treating patients with cancer using minimally invasive, image-guided procedures employing X-ray, ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) to help guide miniaturized instruments (e.g. biopsy needles, ablation electrodes, intravascular catheters) to allow targeted and precise treatment of solid tumours.