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预测可切除直肠癌的早期复发

Predicting early recurrence in resectable rectal cancer.

作者信息

Carmo Silva Manuel, Correia de Sá Tiago, Pereira Kayla P, Pisco Joana M

机构信息

Department of Radiotherapy, ULS Santa Maria, Lisbon 1649-028, Portugal.

Hepatobiliopancreatic Surgery and Transplantation Service, Unidade Local de Saude Santo Antonio, Porto 4150, Portugal.

出版信息

World J Gastrointest Surg. 2025 Aug 27;17(8):101227. doi: 10.4240/wjgs.v17.i8.101227.

Abstract

We provide an editorial of recent findings on early recurrence (ER) in rectal cancer (RC), focusing on the study on ER of resectable RC by Tsai . The study established an 8-month recurrence-free survival cut-off for differentiating ER from late recurrence, with implications for postrecurrence survival and overall survival. This offers not only a valuable timeframe for enhancing surveillance strategies in patients at higher risk, especially those who have undergone neoadjuvant chemoradiotherapy (CRT), but also raises questions about its applicability across different populations. Furthermore, the article suggests that while CRT is very effective in reducing locoregional recurrence, this treatment alone may not fully address the overall risk of ER. The authors advocate for personalized risk assessment and intensive surveillance during the postoperative period to improve outcomes, particularly in the first year. Future research should focus on larger, multicenter studies and incorporate advanced diagnostic techniques with genetic and molecular biomarkers to enhance prediction and management of ER. The ultimate goal is to refine treatment and surveillance strategies to improve survival and quality of life for patients with RC.

摘要

我们提供了一篇关于直肠癌(RC)早期复发(ER)近期研究结果的社论,重点关注蔡等人关于可切除RC的ER研究。该研究确定了一个8个月的无复发生存期临界值,用于区分ER和晚期复发,这对复发后生存和总生存具有重要意义。这不仅为加强对高危患者(尤其是那些接受了新辅助放化疗(CRT)的患者)的监测策略提供了一个有价值的时间框架,也引发了关于其在不同人群中适用性的问题。此外,文章指出,虽然CRT在降低局部区域复发方面非常有效,但仅这种治疗可能无法完全解决ER的总体风险。作者主张进行个性化风险评估,并在术后特别是第一年进行强化监测,以改善治疗结果。未来的研究应侧重于更大规模的多中心研究,并纳入先进的诊断技术以及基因和分子生物标志物,以加强对ER的预测和管理。最终目标是完善治疗和监测策略,以提高RC患者的生存率和生活质量。

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