不手术治疗直肠癌是可行的吗?
Felipe F Quezada-Diaz1, Jesse Joshua Smith2
1Colorectal Unit, Department of Surgery, Complejo Asistencial Doctor Sótero del Río, Santiago, Región Metropolitana, Chile. Electronic address: https://twitter.com/ffquezad.
Advances in surgery
|August 3, 2023
概括
总的新辅助治疗 (TNT) 改善了局部晚期直肠癌 (LARC) 的结果. 非手术管理 (NOM) 是一个可行的选择,但谨慎的患者选择对于保持瘤安全和改善生活质量至关重要.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 在过去的十年中,局部晚期直肠癌 (LARC) 的治疗发生了显著的进化.
- 总的新辅助治疗 (TNT) 已成为一种关键策略,提高了临床和病理完整反应率.
- 使用TNT改善的结果需要重新评估LARC的治疗途径.
研究的目的:
- 探索非操作管理 (NOM) 对LARC的可行性和影响.
- 确定选择NOM最佳候选人的挑战,同时确保瘤安全.
- 倡导将NOM纳入LARC治疗讨论中.
主要方法:
- 对LARC目前的治疗模式的审查.
- 对TNT对反应率的影响分析.
- 对NOM候选人选择标准的评估.
- 考虑患者报告的结果和偏好.
主要成果:
- 在LARC中,TNT显示了临床和病理完整反应的增加率.
- 成功实施NOM取决于准确识别合适的患者.
- 越来越多的完整响应率支持NOM在精选的LARC病例中的潜力.
结论:
- 非手术管理 (NOM) 应该是LARC治疗讨论中的标准考虑.
- NOM提供了潜在的好处,包括改善生活质量和避免外科手术致病率.
- 需要进一步的研究来完善NOM选择标准,并确保LARC患者的长期瘤安全.
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