Yoo Ri Na, Kim Hyung Jin
Division of Colorectal Surgery Department of Surgery St. Vincent's Hospital College of Medicine The Catholic University of Korea Suwon Gyeonggi-do Korea.
Ann Gastroenterol Surg. 2019 Apr 29;3(4):356-367. doi: 10.1002/ags3.12253. eCollection 2019 Jul.
For the past several decades, disease-related outcomes, particularly local recurrence rate, in patients with locally advanced rectal cancer have significantly improved as a result of advancement of surgical technique and implementation of neoadjuvant chemoradiation. However, distant metastasis remains unresolved, being a significant cause of cancer death. To focus on micrometastases early in the course of multimodal treatment, delivering systemic chemotherapy in the neoadjuvant setting is emerging. Also, driven by patient demand and interest in preserving quality of life, upfront chemotherapy prior to surgery serves as a strategy for organ preservation in the management of rectal cancer. Herein, currently available literature on different methods and strategies of the multimodal approach is critically appraised.
在过去几十年中，由于手术技术的进步和新辅助放化疗的实施，局部晚期直肠癌患者与疾病相关的结局，尤其是局部复发率，有了显著改善。然而，远处转移问题仍未得到解决，仍是癌症死亡的一个重要原因。为了在多模式治疗过程的早期关注微转移，在新辅助治疗阶段进行全身化疗的做法正在兴起。此外，受患者对保留生活质量的需求和兴趣驱动，术前先行化疗成为直肠癌治疗中器官保留的一种策略。在此，对目前关于多模式治疗不同方法和策略的现有文献进行批判性评价。
