Wei Iris H, Garcia-Aguilar Julio
Colorectal Service, Department of Surgery, Memorial Sloan Kettering, New York, NY, USA -
Colorectal Service, Department of Surgery, Memorial Sloan Kettering, New York, NY, USA.
Minerva Chir. 2018 Dec;73(6):601-618. doi: 10.23736/S0026-4733.18.07743-X. Epub 2018 May 24.
The management of locally-advanced rectal cancer involves a combination of chemotherapy, chemoradiation, and surgical resection to provide excellent local tumor control and overall survival. However, aspects of this multimodality approach are associated with significant morbidity and long-term sequelae. In addition, there is growing evidence that patients with a clinical complete response to chemotherapy and chemoradiation treatments may be safely offered initial non-operative management in a rigorous surveillance program. Weighed against the morbidity and significant sequelae of rectal resection, recognizing how to best optimize non-operative strategies without compromising oncologic outcomes is critical to our understanding and treatment of this disease.
局部晚期直肠癌的治疗包括化疗、放化疗和手术切除相结合，以实现良好的局部肿瘤控制和总体生存。然而，这种多模式治疗方法的某些方面会带来显著的发病率和长期后遗症。此外，越来越多的证据表明，对化疗和放化疗有临床完全缓解的患者，在严格的监测计划下，可以安全地进行初始非手术治疗。权衡直肠切除的发病率和严重后遗症，认识到如何在不影响肿瘤学结果的情况下最佳优化非手术策略，对于我们对这种疾病的理解和治疗至关重要。
