Yao Shiya, Lan Huanrong, Han Yuejun, Mao Chunsen, Yang Mengxiang, Zhang Xuan, Jin Ketao
Department of Colorectal Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang 321000, China.
Department of Surgical Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China.
Surg Open Sci. 2023 Aug 9;15:44-53. doi: 10.1016/j.sopen.2023.07.024. eCollection 2023 Sep.
The emergence of immunotherapy has revolutionized the traditional treatment paradigm of colorectal cancer (CRC). Among them, immune checkpoint blockade has become the first-line treatment for metastatic colorectal cancer (mCRC) and has made significant progress in the treatment of locally advanced colorectal cancer (LACRC). We reviewed a series of clinical trials that have made breakthrough progress. We will emphasize the breakthrough progress in achieving organ preservation in patients with high microsatellite instability or DNA mismatch repair deficiency (MSI-H/dMMR), and based on this, we propose the concept of selective surgery, which includes selectively removing or preserving lymph nodes, with the aim of proving our idea through more research in the future.
免疫疗法的出现彻底改变了结直肠癌（CRC）的传统治疗模式。其中，免疫检查点阻断已成为转移性结直肠癌（mCRC）的一线治疗方法，并在局部晚期结直肠癌（LACRC）的治疗中取得了重大进展。我们回顾了一系列取得突破性进展的临床试验。我们将强调在微卫星高度不稳定或DNA错配修复缺陷（MSI-H/dMMR）患者中实现器官保留方面的突破性进展，并在此基础上提出选择性手术的概念，包括选择性地切除或保留淋巴结，目的是通过未来更多的研究来证明我们的想法。
