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直肠癌新辅助同期放化疗后机器人辅助全直肠系膜切除术的肿瘤学结果。

Oncological outcomes of robotic-assisted total mesorectal excision after neoadjuvant concurrent chemoradiotherapy in patients with rectal cancer.

机构信息

Division of Colorectal Surgery, Department of Surgery, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung, Taiwan; Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Asian J Surg. 2021 Jul;44(7):957-963. doi: 10.1016/j.asjsur.2021.01.018. Epub 2021 Feb 20.


DOI:10.1016/j.asjsur.2021.01.018
PMID:33622595
Abstract

AIMS: This study analyzed the oncological outcomes of robotic-assisted total mesorectal excision (TME) in patients with rectal cancer after neoadjuvant concurrent chemoradiotherapy (CCRT). METHODS: We enrolled 109 consecutive patients with stage II-III rectal cancer who underwent robotic-assisted TME after neoadjuvant CCRT at one hospital between July 2013 and June 2018. RESULTS: All 109 patients underwent preoperative CCRT. Of them, 37 (33.9%) achieved a pathologic complete response, and 29 (26.6%) experienced relapse, with local recurrence in 9 (8.3%) and distant metastasis in 20 (18.3%). R0 resection was performed in 104 (95.7%) patients; however, 7 (6.7%) of them developed local recurrence and 17 (16.3%) developed distant metastasis. Over a median follow-up of 42 months, the 3-year disease-free survival and overall survival rates were 73.4% and 87.2%, respectively. CONCLUSIONS: Robotic-assisted TME after neoadjuvant CCRT is safe and effective for treating patients with stage II-III rectal cancer in one institution with acceptable short-term oncological outcomes. It may be a therapeutic alternative to salvage surgery for T4 tumors invading adjacent organs, such as the bladder, prostate, and uterus.

摘要

目的:本研究分析了新辅助同步放化疗(CCRT)后接受机器人辅助全直肠系膜切除术(TME)的直肠癌患者的肿瘤学结果。

方法:我们纳入了 2013 年 7 月至 2018 年 6 月期间在一家医院接受新辅助 CCRT 后行机器人辅助 TME 的 109 例连续 II-III 期直肠癌患者。

结果:所有 109 例患者均接受了术前 CCRT。其中,37 例(33.9%)达到病理完全缓解,29 例(26.6%)出现复发,9 例(8.3%)局部复发,20 例(18.3%)远处转移。104 例(95.7%)患者行 R0 切除术,但其中 7 例(6.7%)发生局部复发,17 例(16.3%)发生远处转移。中位随访 42 个月,3 年无病生存率和总生存率分别为 73.4%和 87.2%。

结论:在一家机构中,新辅助 CCRT 后行机器人辅助 TME 治疗 II-III 期直肠癌安全有效,短期肿瘤学结果可接受。对于侵犯相邻器官(如膀胱、前列腺和子宫)的 T4 肿瘤,它可能是挽救性手术的治疗选择。

相似文献

[1]
Oncological outcomes of robotic-assisted total mesorectal excision after neoadjuvant concurrent chemoradiotherapy in patients with rectal cancer.

Asian J Surg. 2021-7

[2]
[Comparison of long-term efficacy between watch and wait strategy and total mesorectal excision in locally advanced rectal cancer patients with clinical complete response after neoadjuvant therapy].

Zhonghua Wei Chang Wai Ke Za Zhi. 2020-3-25

[3]
Robotic-assisted total mesorectal excision with the single-docking technique for patients with rectal cancer.

BMC Surg. 2017-12-5

[4]
An observational study of patho-oncological outcomes of various surgical methods in total mesorectal excision for rectal cancer: a single center analysis.

BMC Surg. 2020-2-3

[5]
Time interval between the completion of radiotherapy and robotic-assisted surgery among patients with stage I-III rectal cancer undergoing preoperative chemoradiotherapy.

PLoS One. 2020-10-16

[6]
Long-term oncological outcomes of robotic versus laparoscopic total mesorectal excision of mid-low rectal cancer following neoadjuvant chemoradiation therapy.

Surg Endosc. 2017-4

[7]
[Rectum-preserving surgery after consolidation neoadjuvant therapy or totally neoadjuvant therapy for low rectal cancer: a preliminary report].

Zhonghua Wei Chang Wai Ke Za Zhi. 2020-3-25

[8]
Adjuvant Chemotherapy Does Not Improve Recurrence-Free Survival in Patients With Stage 2 or Stage 3 Rectal Cancer After Neoadjuvant Chemoradiotherapy and Total Mesorectal Excision.

Dis Colon Rectum. 2020-4

[9]
Local excision versus total mesorectal excision for rectal cancer patients with clinical complete or near-complete response after neoadjuvant chemoradiotherapy.

Int J Colorectal Dis. 2024-10-8

[10]
Surgery with versus without preoperative concurrent chemoradiotherapy for mid/low rectal cancer: an interim analysis of a prospective, randomized trial.

Chin J Cancer. 2015-6-10

引用本文的文献

[1]
Combined TaTME with SP Robot for Low Anterior Resection in Rectal Cancer: rSPa TaTME.

Cancers (Basel). 2025-4-15

[2]
Smoking and Elevated Preneoadjuvant Chemoradiotherapy Serum Carcinoembryonic Antigen Levels Are Associated With High Tumor Regression Grade and Poor Survival in Patients With Locally Advanced Rectal Cancer.

Kaohsiung J Med Sci. 2025-6

[3]
Standardize the surgical technique and clarify the oncologic significance of robotic D3-D4 lymphadenectomy for upper rectum and sigmoid colon cancer with clinically more than N2 lymph node metastasis.

Int J Surg. 2024-4-1

[4]
Association between personality types and low anterior resection syndrome in rectal cancer patients following surgery.

Cancer Med. 2024-2

[5]
The Auxiliary Effects of Low-Molecular-Weight Fucoidan in Locally Advanced Rectal Cancer Patients Receiving Neoadjuvant Concurrent Chemoradiotherapy Before Surgery: A Double-Blind, Randomized, Placebo-Controlled Study.

Integr Cancer Ther. 2023

[6]
The effect of carbon nanoparticles staining on lymph node tracking in colorectal cancer: A propensity score matching analysis.

Front Surg. 2023-3-1

[7]
Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer.

Curr Oncol. 2023-1-12

[8]
Clinical Safety and Effectiveness of Robotic-Assisted Surgery in Patients with Rectal Cancer: Real-World Experience over 8 Years of Multiple Institutions with High-Volume Robotic-Assisted Surgery.

Cancers (Basel). 2022-8-29

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