Yao H W, Liu Y H
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing 100050, China.
Zhonghua Wai Ke Za Zhi. 2017 Jul 1;55(7):496-499. doi: 10.3760/cma.j.issn.0529-5815.2017.07.004.
Neo-adjuvant chemoradiotherapy (NACRT) combined with total mesorectal excision (TME) surgery is the main treatment for locally advanced middle-low rectal cancer, and NACRT significantly improves the local control rate of rectal cancer. According to the current guidelines, patients who receive clinical complete response (cCR) after NACRT are recommended for treatment with TME surgery. A few studies have shown that the watch-and-wait (WAW) policy is safe and could ensure anorectal function and quality of life in patients with cCR. In addition, such patients must be closely observed and followed up so as to enable salvage surgery for long periods of tumor re-growth. However, there is not enough evidence to provide a clear answer to the oncological effect of the WAW policy. As a result, WAW policy is not widely available in clinical practice, and further prospective studies are needed to assess its risk and benefit for the patients.
新辅助放化疗（NACRT）联合全直肠系膜切除术（TME）是局部进展期低位直肠癌的主要治疗方法，NACRT显著提高了直肠癌的局部控制率。根据现行指南，新辅助放化疗后达到临床完全缓解（cCR）的患者建议行TME手术治疗。一些研究表明，观察等待（WAW）策略是安全的，并且可以确保cCR患者的肛门直肠功能和生活质量。此外，对此类患者必须密切观察和随访，以便在肿瘤长期复发时能够进行挽救性手术。然而，目前尚无足够证据明确WAW策略的肿瘤学疗效。因此，WAW策略在临床实践中并未广泛应用，需要进一步的前瞻性研究来评估其对患者的风险和益处。
