Department of General Surgery, Münsingen Hospital, Inselgruppe, Bern, Switzerland.
Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland.
Eur J Surg Oncol. 2022 Apr;48(4):822-833. doi: 10.1016/j.ejso.2021.10.004. Epub 2021 Oct 10.
Metastatic spread to the rectum is a rare finding, and management of rectal metastases (RM) is not standardized. The aim of the present study was to review the evidence on diagnosis, management and outcomes of RM.
A computerized literature search through MEDLINE/PubMed, Embase and the Cochrane databases was performed, applying a combination of terms related to RM. Articles and abstracts were screened and final selection was done after cross-referencing and by use of predefined eligibility criteria.
Final analysis was based on 99 publications totaling 162 patients with RM from 16 different primary tumors. Most common origins of RM were breast (42 patients), stomach (38 patients), and prostate (16 patients). RM occurred metachronously in the majority of patients (77%). The main treatment was surgical resection (n = 32), followed by chemotherapy (n = 16). Median overall survival for breast RM, stomach RM, and prostate RM were 24 months (95% CI 9-39 months), 7 months (95% CI 0-14 months), and 24 months (95% CI 7-41 months), respectively.
RM is a rare and highly heterogeneous condition. Surgical treatment appears to be a valuable treatment option in selected patients, while overall prognosis depends mainly on the primary tumor.
直肠转移是一种罕见的发现，直肠转移瘤（RM）的治疗尚未标准化。本研究旨在回顾 RM 的诊断、治疗和预后的证据。
通过 MEDLINE/PubMed、Embase 和 Cochrane 数据库进行计算机文献检索，应用与 RM 相关的术语组合。筛选文章和摘要，并通过交叉参考和使用预定义的纳入标准进行最终选择。
最终分析基于 99 篇文献，共计 162 例来自 16 种不同原发性肿瘤的 RM 患者。RM 最常见的起源是乳腺（42 例）、胃（38 例）和前列腺（16 例）。大多数患者（77%）RM 为异时性发生。主要治疗方法是手术切除（n=32），其次是化疗（n=16）。乳腺 RM、胃 RM 和前列腺 RM 的中位总生存期分别为 24 个月（95%CI 9-39 个月）、7 个月（95%CI 0-14 个月）和 24 个月（95%CI 7-41 个月）。
RM 是一种罕见且高度异质性的疾病。手术治疗似乎是一种有价值的治疗选择，适用于某些患者，而总体预后主要取决于原发性肿瘤。
