完全临床缓解的管理
Management of the Complete Clinical Response.
作者信息
Habr-Gama Angelita, São Julião Guilherme Pagin, Vailati Bruna Borba, Castro Ivana, Raffaele Debora
机构信息
Angelita & Joaquim Gama Institute, Sao Paulo, SP, Brazil.
University of Sao Paulo School of Medicine, Sao Paulo, SP, Brazil.
出版信息
Clin Colon Rectal Surg. 2017 Nov;30(5):387-394. doi: 10.1055/s-0037-1606116. Epub 2017 Nov 27.
Abstract
Organ preservation is considered in the management of selected patients with rectal cancer. Complete clinical response observed after neoadjuvant chemoradiation for rectal cancer is one of these cases. Patients who present complete clinical response are candidates to the watch-and-wait approach, when radical surgery is not immediately performed and is offered only to patients in the event of a local relapse. These patients are included in a strict follow-up, and up of 70% of them will never be operated during the follow-up. This strategy is associated with similar oncological outcomes as patients operated on, and the advantage of avoiding the morbidity associated to the radical operation. In this article we will discuss in detail the best candidates for this approach, the protocol itself, and the long-term outcomes.
摘要
在特定直肠癌患者的治疗中会考虑器官保留。直肠癌新辅助放化疗后观察到的完全临床缓解就是其中一种情况。出现完全临床缓解的患者是观察等待策略的候选对象，此时不立即进行根治性手术，仅在局部复发时才对患者进行手术。这些患者被纳入严格的随访，随访期间高达70%的患者不会接受手术。该策略与接受手术的患者具有相似的肿瘤学结局，且具有避免根治性手术相关并发症的优势。在本文中，我们将详细讨论这种方法的最佳候选对象、方案本身以及长期结局。
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