Current controversies about rectal cancer treatment are examined and discussed in this book. In particular, oncologic outcomes, which claim an aggressive approach over the primary tumour, lymph nodes and distant metastasis. Also, the functional outcome, whose important objective is to preserve the anal sphincter and the preservation of the pelvic nervous plexus. Radical resection with total mesorectal excision is the mainstay of rectal cancer treatment. However, it is associated with significant surgical morbidity/mortality, possible stoma surgery/complications and long-term gastrointestinal dysfunction with deterioration in quality of life. This book also explores the risk factors of local recurrence after curative resection in patients with middle and lower rectal carcinoma. The relationships between mesorectal metastasis and local recurrence and the possible correlations between circumferential resection margin status and local recurrence were identified. The relationships between local recurrence and clinicopathologic characteristics of middle and lower rectal carcinoma were also evaluated.