Department of Radiation Oncology, Catharina Hospital, Michelangelolaan 2 5623EJ, Eindhoven, the Netherlands; Department of Radiation Oncology, The Netherlands Cancer Institute, Plesmanlaan 121 1066 CX, Amsterdam, the Netherlands; Department of Radiation Oncology, Leiden University Medical Centre, Albinusdreef 2 2333ZA, Leiden, the Netherlands.
GROW School of Oncology and Developmental Biology, University of Maastricht, Universiteitssingel 40 6229ER, Maastricht, the Netherlands; Department of Surgery, Catharina Hospital, Michelangelolaan 2 5623EJ, Eindhoven, the Netherlands.
Cancer Treat Rev. 2024 Jun;127:102736. doi: 10.1016/j.ctrv.2024.102736. Epub 2024 Apr 19.
Due to improvements in treatment for primary rectal cancer, the incidence of LRRC has decreased. However, 6-12% of patients will still develop a local recurrence. Treatment of patients with LRRC can be challenging, because of complex and heterogeneous disease presentation and scarce - often low-grade - data steering clinical decisions. Previous consensus guidelines have provided some direction regarding diagnosis and treatment, but no comprehensive guidelines encompassing all aspects of the clinical management of patients with LRRC are available to date. The treatment of LRRC requires a multidisciplinary approach and overarching expertise in all domains. This broad expertise is often limited to specific expert centres, with dedicated multidisciplinary teams treating LRRC. A comprehensive, narrative literature review was performed and used to develop the Dutch National Guideline for management of LRRC, in an attempt to guide decision making for clinicians, regarding the complete clinical pathway from diagnosis to surgery.
由于原发性直肠癌治疗的改进，LRRC 的发病率已经下降。然而，仍有 6-12%的患者会出现局部复发。LRRC 患者的治疗可能具有挑战性，因为疾病表现复杂且具有异质性，而且可供指导临床决策的数据很少——往往是低级别数据。以前的共识指南为诊断和治疗提供了一些指导，但迄今为止，尚无涵盖 LRRC 患者临床管理所有方面的综合指南。LRRC 的治疗需要多学科的方法和在所有领域的全面专业知识。这种广泛的专业知识通常仅限于特定的专家中心，专门的多学科团队治疗 LRRC。进行了全面的叙述性文献综述，并用于制定荷兰 LRRC 管理国家指南，试图为临床医生提供指导，以制定从诊断到手术的完整临床路径的决策。
