Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623, EJ Eindhoven, The Netherlands,
Curr Oncol Rep. 2014 Mar;16(3):372. doi: 10.1007/s11912-013-0372-y.
The management of rectal cancer has improved considerably in recent decades. Surgery remains the cornerstone of the treatment. However, the role of preoperative imaging has made it possible to optimize the treatment plan in rectal patients. Neoadjuvant treatment may be indicated in efforts to sterilize possible tumor deposits outside the surgical field, or may be used to downsize and downstage the tumor itself. The optimal sequence of treatment modalities can be determined by a multidisciplinary team, who not only use pretreatment imaging, but also review pathologic results after surgery. The pathologist plays a pivotal role in providing feedback about the success of surgery, i.e., the distance between the tumor and the circumferential resection margin, the quality of surgery, and the effect of neoadjuvant treatment. Registry and auditing of all treatment variables can further improve outcomes. In this century, rectal cancer treatment has become a team effort.
近年来，直肠癌的治疗取得了显著进展。手术仍然是治疗的基石。然而，术前影像学的作用使得直肠患者的治疗方案得以优化。新辅助治疗可能适用于消灭手术区域外可能存在的肿瘤沉积物，也可能用于缩小和降期肿瘤本身。多学科团队可以确定最佳的治疗方式顺序，他们不仅使用术前影像学，还会在手术后审查病理结果。病理学家在提供手术成功的反馈方面起着关键作用，即肿瘤与环周切缘的距离、手术质量以及新辅助治疗的效果。对所有治疗变量进行登记和审核可以进一步改善治疗效果。在本世纪，直肠癌的治疗已成为一项团队工作。
