术前放射和/或化疗后的直肠节约方法 (ReSARCh):一个前性,多中心的观察性研究
Gaya Spolverato1, Quoc Riccardo Bao1, Paolo Delrio2
1General Surgery 3, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padova.
International journal of surgery (London, England)
|March 22, 2024
概括
在新辅助疗法后获得完整反应的直肠癌患者可以在约80%的病例中保存直肠. 这种节省直肠的方法显示出有希望的结果,而不会影响生存率.
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:
- 结直肠节约方法正在出现,用于结直肠癌患者的整体或主要响应后的新辅助疗法.
- 这些方法的可行性和结果仍在调查和辩论中.
- 这项研究旨在评估保护直肠的有效性,而不会对患者的治疗结果产生负面影响.
研究的目的:
- 评估直肠节约策略在直肠癌管理中的可行性.
- 为了确定直肠保护是否影响瘤和生存结果.
- 为了调查经过门的局部切除或观察和等待方法后的结果.
主要方法:
- 一项前性,多中心的观察性研究,涉及178名临床阶段II-III中低直肠腺癌患者.
- 患者接受了新辅助疗法,随后进行过道局部切除或观察和等待策略.
- 主要终点是直肠的保存;次要终点包括整体存活率,无病存活率,复发率和3年无口腔存活率.
主要成果:
- 在患者中,直肠在80.9%的患者中被保存,随访时间中位数为36.1个月.
- 三年生存率很高:整体存活率 (97.6%),无病存活率 (90.0%),局部无复发存活率 (94.7%) 和远程无复发存活率 (94.6%).
- 在观察和等待组中,无静脉瘤的3年生存率为95.0%,无再生细胞的生存率为71.8%.
结论:
- 在大约80%的直肠癌患者中,直肠保护是可行的,这些患者对新辅助疗法有重大或完全的反应.
- 这些直肠节约方法可以在不影响瘤结果或生存的情况下进行.
- 这些发现支持在精选的直肠癌患者中考虑器官保存策略.
相关概念视频
Radiological Investigation III: Pulmonary Angiogram and PET Scan
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Imaging Studies II: Positron Emission Tomography and Scintigraphy
Positron Emission Tomography (PET) is a medical imaging technique that provides crucial insights into the body's physiological functions at a molecular level. It is an indispensable resource for diagnosing, staging, and monitoring various illnesses, notably cancer, neurological disorders, and cardiovascular conditions.
Fundamental Principles of PET
Fundamental Principles of PET
Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Endoscopic Procedures V: ERCP
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...


