Department of Gastroenterological Oncology, M. Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland.
Department of Gastroenterological Oncology, M. Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
Best Pract Res Clin Gastroenterol. 2024 Feb;68:101896. doi: 10.1016/j.bpg.2024.101896. Epub 2024 Feb 28.
The conventional approach to treating locally advanced rectal cancer, commonly defined as cT3 or cT4 primary tumors or with nodal metastases, involves chemoradiation (CRT) followed by surgical resection. There is a growing recognition of the potential for nonsurgical management following CRT or total neoadjuvant therapy (TNT), which allows for organ preservation. "Watch and wait" strategy may be considered if complete clinical response is achieved. In cases when adenoma or superficial cancer is present, a novel approach known as "salvage endoscopic resection of the residual disease" is emerging as a viable nonsurgical option for carefully selected patients. This review discusses available evidence and future potential for endoscopic management of residual neoplasia after oncological treatment of rectal cancer.
治疗局部晚期直肠癌的传统方法通常是指 cT3 或 cT4 原发肿瘤或有淋巴结转移的患者，采用放化疗（CRT）后再进行手术切除。人们越来越认识到 CRT 或新辅助全直肠系膜切除术（TNT）后非手术治疗的潜力，这可以保留器官。如果达到完全临床缓解，可以考虑“观察等待”策略。如果存在腺瘤或表浅性癌症，一种新的方法，即“残留疾病的挽救性内镜切除术”，作为一种可行的非手术选择，正在为精心挑选的患者出现。本文综述了直肠癌肿瘤治疗后残留肿瘤内镜治疗的现有证据和未来潜力。
