Mullaney Tamara G, Lightner Amy L, Johnston Michael, Keck James, Wattchow David
Department of Colorectal Surgery, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Department of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA.
ANZ J Surg. 2018 Sep;88(9):836-841. doi: 10.1111/ans.14352. Epub 2018 Jul 25.
Surgery remains the cornerstone of rectal cancer treatment. However, there is significant morbidity and mortality associated with pelvic surgery, and the past decade has illustrated that a cohort of rectal cancer patients sustain a remission of local disease with chemoradiation alone. Thus, questions remain regarding the optimal management for rectal cancer; namely, accurately identifying patients who have a complete pathologic response and determining the oncologic safety of the observational approach for this patient group. This review aims to summarize the current evidence to provide an overview to the 'watch and wait' approach in rectal cancer patients with a complete response to neoadjuvant chemoradiation therapy.
手术仍然是直肠癌治疗的基石。然而,盆腔手术存在显著的发病率和死亡率,并且过去十年已经表明,一部分直肠癌患者仅通过放化疗就能实现局部疾病缓解。因此,关于直肠癌的最佳治疗方案仍存在疑问;即,准确识别具有完全病理缓解的患者,并确定该患者群体观察性治疗方法的肿瘤学安全性。本综述旨在总结当前证据,以概述对新辅助放化疗有完全反应的直肠癌患者的“观察等待”方法。