What would be the recommended management for patients with rectal adenocarcinoma with rectovaginal fistula at presentation?

Diverting colostomy, preop RT chemo, and surgery.

Agree with Dr. @Dr. First Last that would request a temporary diverting colostomy before proceeding with preoperative chemo-radiation. For patients with T3N0-N+ lesions, would use an IMRT approach to deliver 45Gy/25Fx to extended field and 50.4-54 Gy in boost field; for those with T4N0-N+ lesions, 5...