The paper gives the results of treatment for cancer of the lower rectal ampulla. The approach to its management must be multidisciplinary. The development of surgery for rectal cancer follows two main directions: to maintain function without worsening oncological results and to use more and more expanded surgical interventions. Both pre- and postoperative radiation and chemoradiation therapies using different fractionation procedures have provided strong evidence for their appropriateness. Particular attention is now given to the searches and development of predictors for the efficiency of preoperative radiation/chemoradiation therapies.