Department of Colorectal and Anal Surgery, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, 442008, PR China.
Department of Colorectal and Anal Surgery, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, 442008, PR China.
Cryobiology. 2023 Jun;111:121-125. doi: 10.1016/j.cryobiol.2023.05.004. Epub 2023 May 12.
Sphincter preserving therapy is a key research focus for treating low rectal cancer; however, the role of cryotherapy in this process has seldom been reported in the literature. Therefore, we conducted a comprehensive report on the role of cryoablation in sphincter preservation and explored its effect in rectal cancers. An observational study used longitudinal observation and follow-up. Participants were screened from patients whose medical records showed cryotherapy intervention for low rectal cancers from January 2016 to December 2020, with more than 2 years of follow-up. The primary endpoint was progress-free survival, and the secondary outcomes were mainly related to sphincter preservation rate and complications. Thirty-five patients were enrolled in this study, all of whom had their sphincters preserved. Until June 2022, 35 cases achieved long-term progression-free survival (41.77 ± 15.58), with no recurrence observed in 88.57% (31/35) of all patients at follow-up. Cryotherapy showed no significant differences in progress-free survival between sexes (p > 0.05). Cox regression was used to analyze the factors affecting local recurrence, with sex, T stage, size, and cryo-time taken as covariates. The results showed that T stage was a risk factor for local recurrence (p = 0.01, odds ratio: 16.27, 95% confidence interval: 8.20,145.75). Analysis of the T stage according to different subgroups showed that T3 stage was an independent risk factor (p = 0.002). We observed seven cases of complications, which were classified into grades I-II. In patients with low rectal cancers, cryotherapy can safely and effectively preserve the anus and avoid low anterior resection syndrome. Cryoablation has a better curative effect on radical treatment, especially for tumors in the T- NM stage.
保肛治疗是治疗低位直肠癌的一个重要研究方向，然而，冷冻疗法在这一过程中的作用在文献中鲜有报道。因此，我们就冷冻消融在保肛治疗中的作用进行了全面的报告，并探讨了其在直肠癌中的疗效。采用纵向观察和随访的观察性研究。从 2016 年 1 月至 2020 年 12 月接受低位直肠癌冷冻治疗的患者的病历中筛选出参与者，随访时间超过 2 年。主要终点是无进展生存期，次要结局主要与保肛率和并发症有关。本研究共纳入 35 例患者，所有患者均保留了肛门。截至 2022 年 6 月，35 例患者均达到了长期无进展生存（41.77±15.58），随访时所有患者中有 88.57%（31/35）未见复发。冷冻治疗在无进展生存期方面，不同性别间差异无统计学意义（p＞0.05）。采用 Cox 回归分析影响局部复发的因素，以性别、T 分期、大小和冷冻时间为协变量。结果显示，T 分期是局部复发的危险因素（p=0.01，比值比：16.27，95%置信区间：8.20，145.75）。根据不同亚组分析 T 分期显示，T3 期是独立的危险因素（p=0.002）。我们观察到 7 例并发症，分为 1-2 级。在低位直肠癌患者中，冷冻治疗能安全有效地保留肛门，避免低位前切除综合征。冷冻消融对根治性治疗效果较好，尤其是 T 期-NM 期肿瘤。
