Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
Montpellier Cancer Research Institute, IRCM, Montpellier Cancer Research Institute, 208 Ave des Apothicaires, 34295, Montpellier, France.
Abdom Radiol (NY). 2019 Nov;44(11):3709-3725. doi: 10.1007/s00261-019-02003-5.
Despite advances in surgical techniques and chemoradiation therapy, recurrent rectal cancer remains a cause of morbidity and mortality. After successful treatment of rectal cancer, patients are typically enrolled in a surveillance strategy that includes imaging as studies have shown improved prognosis when recurrent rectal cancer is detected during imaging surveillance versus based on development of symptoms. Additionally, patients who experience a complete clinical response with chemoradiation therapy may elect to enroll in a "watch-and-wait" strategy that includes imaging surveillance rather than surgical resection. Factors that increase the likelihood of recurrence, patterns of recurrence, and the imaging appearances of recurrent rectal cancer are reviewed with a focus on CT, PET CT, and MR imaging.
尽管手术技术和放化疗取得了进展，但复发性直肠癌仍然是发病率和死亡率的原因。直肠癌成功治疗后，患者通常会接受监测策略，包括影像学检查，因为研究表明，在影像学监测中检测到复发性直肠癌时，预后会有所改善，而不是基于症状的发展。此外，接受放化疗后完全临床缓解的患者可能会选择参加“观察等待”策略，该策略包括影像学监测而不是手术切除。本文重点介绍 CT、PET CT 和 MRI，回顾了增加复发可能性的因素、复发模式以及复发性直肠癌的影像学表现。
