Moriya Yoshihiro
Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 2005 Apr;106(4):302-5.
The author reviewed recent results of Japanese and international studies on preoperative staging, pathology of bisopied specimens, sentinel node navigation surgery, and single tumor cells in rectal cancer. Preoperative staging with high accuracy is possible using high spatial MRI imaging. Examination of circumferential resection margins is incompatible with that of lymph nodes Intersphincteric resection can be an alternative to abdominoperineal resection for selected rectal tumors located at the anorectal junction without compromising the chance for cure. Although information on sentinel node navigation surgery and isolated single cells has accumulated, the selection of surgical procedures should not be based on these investigations. We emphasize that multiinstitutional clinical trials of adjuvant chemoradiotherapy and surgical treatment are indispensable for developing treatments for rectal cancer in Japan.
作者回顾了日本和国际上关于直肠癌术前分期、活检标本病理学、前哨淋巴结导航手术以及单个肿瘤细胞的近期研究结果。使用高空间分辨率的MRI成像可以实现高精度的术前分期。环周切缘检查与淋巴结检查不能同时进行。对于位于肛管直肠交界处的特定直肠肿瘤，括约肌间切除术可作为腹会阴联合切除术的替代方案，且不影响治愈机会。尽管关于前哨淋巴结导航手术和孤立单个细胞的信息已经积累，但手术方式的选择不应基于这些研究。我们强调，在日本，辅助放化疗和手术治疗的多机构临床试验对于开发直肠癌治疗方法是必不可少的。
