Spiliotis J D, Datsis A C
Department of Surgery, Messologi General Hospital, Messologi, Greece.
J BUON. 2007 Jan-Mar;12(1):23-7.
Local excision has a limited but important role in the modern management of patients with rectal tumors. The main criticism of the local treatment of early rectal cancer (T1N0M0 or T2N0M0) is the neglect of any potential metastatic mesorectal lymph nodes. This article presents the combined experience of several trials and indicates that neoadjuvant preoperative or adjuvant postoperative treatment may reduce the risk of local recurrence in a selected group of patients, and local excision results in overall survival comparable to the most aggressive treatment. Although the hypothetical improvement in morbidity and quality of life with local excision has not been demonstrated, the advantages of the local excision vs. radical surgery in the oncologic results seem obvious and require prospective randomized studies comparing both types of treatment.
局部切除在直肠癌患者的现代治疗中具有有限但重要的作用。对早期直肠癌（T1N0M0或T2N0M0）进行局部治疗的主要批评在于忽视了任何潜在的转移性直肠系膜淋巴结。本文介绍了多项试验的综合经验，并表明新辅助术前或辅助术后治疗可能会降低特定患者群体的局部复发风险，且局部切除的总体生存率与最积极的治疗相当。尽管局部切除在发病率和生活质量方面的假设性改善尚未得到证实，但在肿瘤学结果方面，局部切除相对于根治性手术的优势似乎很明显，需要进行前瞻性随机研究来比较这两种治疗方式。
