Dworak O, Keilholz L, Hoffmann A
Abteilung für Pathologie in der Chirurgischen Klinik, Erlangen, Germany.
Int J Colorectal Dis. 1997;12(1):19-23. doi: 10.1007/s003840050072.
The standard therapy for rectal carcinoma is surgical, however, preoperative radiochemotherapy will play an increasing role especially in locally advanced disease. To estimate the prognosis and the effect of radiochemotherapy the postradiochemotherapeutical pathological features are important to assess. We examined the surgical specimens of 17 patients after preoperative radiochemotherapy to estimate and grade the histological reactions. A proposal for a grading system for tumor regression (not yet available in the literature) has also been described. All but one of the carcinomas showed different degrees of tumor regression. A total regression was not observed after standardised pathological work up. In only one case a locally curative resection was not possible. We think that preoperative radiochemotherapy is able to reduce tumor mass thus achieving operability in non-curatively operable cases. We recommend standards of pathological work up and regression grading for further studies comparing surgery and radiochemotherapy of rectal carcinoma.
直肠癌的标准治疗方法是手术，但术前放化疗在局部晚期疾病中发挥着越来越重要的作用。为了评估预后和放化疗效果，放化疗后的病理特征对于评估很重要。我们检查了17例术前放化疗患者的手术标本，以评估和分级组织学反应。还描述了一种肿瘤消退分级系统的建议（文献中尚未有）。除1例之外，所有癌均显示出不同程度的肿瘤消退。经过标准化病理检查后未观察到完全消退。仅1例无法进行局部根治性切除。我们认为术前放化疗能够减少肿瘤体积，从而在无法进行根治性手术的病例中实现可手术性。我们建议制定病理检查和消退分级标准，以用于进一步比较直肠癌手术和放化疗的研究。
