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直肠癌的非手术治疗:观察与等待策略。

Nonoperative Management of Rectal Cancer: The Watch and Wait Strategy.

机构信息

Angelita & Joaquim Gama Institute, Sao Paulo, Brazil; Hospital Alemão Oswaldo Cruz, Sao Paulo, Brazil; Hospital Beneficência Portuguesa, Sao Paulo, Brazil.

Angelita & Joaquim Gama Institute, Sao Paulo, Brazil; Hospital Alemão Oswaldo Cruz, Sao Paulo, Brazil; Colorectal Surgery Division, University of São Paulo School of Medicine, Sao Paulo, Brazil.

出版信息

Surg Oncol Clin N Am. 2022 Apr;31(2):171-182. doi: 10.1016/j.soc.2021.11.003. Epub 2022 Mar 9.

Abstract

In recent decades, rectal cancer management has become increasingly challenging for multiple reasons. Proper imaging using dedicated magnetic resonance, standardization of total mesorectal excision, and incorporation of neoadjuvant treatment regimens have contributed to a significant decrease in local recurrence rates. The observation of complete tumor response to radiation or chemoradiation led to the proposal of organ-preservation strategies with avoidance of immediate surgery and close surveillance (Watch and Wait strategy) in selected patients. The purpose of this article is to review the current evidence related to the selection criteria and outcomes in patients enrolled in this Watch and Wait strategy.

摘要

近几十年来,由于多种原因,直肠癌的治疗变得越来越具有挑战性。专用磁共振的适当成像、全直肠系膜切除术的标准化以及新辅助治疗方案的纳入,使得局部复发率显著降低。观察到肿瘤对放射或放化疗完全有反应,导致在选定的患者中提出了避免立即手术和密切监测的器官保留策略(观察等待策略)。本文的目的是回顾与该观察等待策略中入组患者的选择标准和结果相关的现有证据。

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