Colorectal Unit, Department of Surgery, Complejo Asistencial Doctor Sótero del Río, Santiago, Región Metropolitana, Chile. Electronic address: https://twitter.com/ffquezad.
Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue | SR-201, New York, NY 10065, USA.
Adv Surg. 2023 Sep;57(1):141-154. doi: 10.1016/j.yasu.2023.05.001. Epub 2023 Jun 14.
During the past decade, the treatment of locally advanced rectal cancer (LARC) has become more complex. Total neoadjuvant treatment (TNT) has increased the rates of both clinical and pathologic complete response, resulting in improved long-term oncological outcomes. The feasibility to implement nonoperative management (NOM) depends on solving current challenges such as how to correctly identify the best candidates for a NOM without compromising oncologic safety. NOM should be part of the treatment discussion of LARC, considering increasing rates of clinical complete response, potential quality of life gains, avoidance of surgical morbidity, and patient preferences.
在过去的十年中，局部晚期直肠癌（LARC）的治疗变得更加复杂。新辅助治疗（TNT）增加了临床和病理完全缓解的比例，从而改善了长期肿瘤学结果。实施非手术治疗（NOM）的可行性取决于解决当前的挑战，例如如何正确识别 NOM 的最佳候选者而不影响肿瘤学安全性。考虑到临床完全缓解率的提高、潜在的生活质量获益、避免手术发病率以及患者的偏好，NOM 应成为 LARC 治疗讨论的一部分。
