Mohammed Huda, Mohamed Hadeel, Mohamed Nusyba, Sharma Rajat, Sagar Jayesh
Surgery Department, Colorectal Surgery, Luton and Dunstable Hospital, Luton LU4 0DZ, UK.
Faculty of Medicine, University of Khartoum, Khartoum 11115, Sudan.
Cancers (Basel). 2025 Feb 9;17(4):588. doi: 10.3390/cancers17040588.
Colorectal cancer (CRC) is the second most prevalent cause of cancer-related death and the third most common cancer globally. Early-stage rectal cancer is defined by lesions confined to the bowel wall, without extension beyond the submucosa in T1 or the muscularis propria in T2, with no indication of lymph node involvement or distant metastasis. The gold standard for managing rectal cancer is total mesorectal excision (TME); however, it is linked to considerable morbidities and impaired quality of life. There is a growing interest in local resection and non-operative treatment of early RC for organ preservation. Local resection options include three types of transanal endoscopic surgery (TES): transanal endoscopic microsurgery (TEM), transanal endoscopic operations (TEO), and transanal minimally invasive surgery (TAMIS), while endoscopic resection includes endoscopic mucosal resection (EMR), underwater endoscopic mucosal resection (UEMR), and endoscopic submucosal dissection (ESD). Although the oncological outcome of local resection of early rectal cancer is debated in the current literature, some studies have shown comparable outcomes with radical surgery in selected patients. The use of adjuvant and neoadjuvant chemoradiotherapy in early rectal cancer management is also controversial in the literature, but a number of studies have reported promising outcomes. This review focuses on the available literature regarding diagnosis, staging, and management strategies of early rectal cancer and provides possible recommendations.
结直肠癌（CRC）是癌症相关死亡的第二大常见原因，也是全球第三大常见癌症。早期直肠癌定义为局限于肠壁的病变，T1期未超出黏膜下层，T2期未超出固有肌层，且无淋巴结受累或远处转移迹象。直肠癌治疗的金标准是全直肠系膜切除术（TME）；然而，它与相当多的并发症和生活质量受损有关。对于早期直肠癌，为了保留器官，人们对局部切除和非手术治疗的兴趣日益增加。局部切除选择包括三种经肛门内镜手术（TES）：经肛门内镜显微手术（TEM）、经肛门内镜手术（TEO）和经肛门微创手术（TAMIS），而内镜切除包括内镜黏膜切除术（EMR）、水下内镜黏膜切除术（UEMR）和内镜黏膜下剥离术（ESD）。尽管目前文献中对早期直肠癌局部切除的肿瘤学结果存在争议，但一些研究表明，在特定患者中，其结果与根治性手术相当。在早期直肠癌管理中使用辅助和新辅助放化疗在文献中也存在争议，但一些研究报告了有希望的结果。本综述重点关注有关早期直肠癌诊断、分期和管理策略的现有文献，并提供可能的建议。
