Cai Yantao, Li Zhenyang, Gu Xiaodong, Fang Yantian, Xiang Jianbin, Chen Zongyou
Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
Oncol Lett. 2014 Jan;7(1):10-16. doi: 10.3892/ol.2013.1640. Epub 2013 Oct 23.
Locally recurrent rectal cancer (LRRC) is defined as an intrapelvic recurrence following a primary rectal cancer resection, with or without distal metastasis. The treatment of LRRC remains a clinical challenge. LRRC has been regarded as an incurable disease state leading to a poor quality of life and a limited survival time. However, curative reoperations have proved beneficial for treating LRRC. A complete resection of recurrent tumors (R0 resection) allows the treatment to be curative rather than palliative, which is a milestone in medicine. In LRRC cases, the difficulty of achieving an R0 resection is associated with the post-operative prognosis and is affected by several clinical factors, including the staging of the local recurrence (LR), accompanying symptoms, patterns of tumors and combined therapy. The risk factors following primary surgery that lead to an increased rate of LR are summarized in this study, including the surgical, pathological and therapeutic factors.
局部复发性直肠癌(LRRC)定义为原发性直肠癌切除术后盆腔内复发,伴或不伴远处转移。LRRC的治疗仍然是一项临床挑战。LRRC一直被视为一种无法治愈的疾病状态,会导致生活质量低下和生存时间有限。然而,根治性再次手术已被证明对治疗LRRC有益。复发性肿瘤的完全切除(R0切除)可使治疗具有治愈性而非姑息性,这是医学上的一个里程碑。在LRRC病例中,实现R0切除的难度与术后预后相关,并受多种临床因素影响,包括局部复发(LR)的分期、伴随症状、肿瘤类型和综合治疗。本研究总结了导致LR发生率增加的初次手术后的危险因素,包括手术、病理和治疗因素。