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转变和演变的新辅助治疗和外科平台在远端直肠癌中的脏保护:23年的回顾经验

Niyaz Shadmanov¹, Vusal Aliyev², Barıs Bakır³

¹Bogazici Academy for Clinical Sciences, Acisu Street, Apart. No 16, 34357/Beşiktaş, Istanbul, Turkey.

Journal of gastrointestinal cancer

|August 23, 2025

概括

机器人手术,MRI和观察等待策略的进步显著改善了局部晚期直肠癌患者的生存率和器官保存率. 这些创新使得长期的瘤治疗效果在20多年内得到改善.

科学领域:

大肠直肠手术
外科瘤学
医疗技术的发展

背景情况:

在局部晚期直肠癌 (LADRC) 治疗方面取得显著进展.
在过去的二十年中,新辅助治疗 (NAT) 方案和手术技术取得了进步.
一位大批量结肠直肠外科医生的实践反映了这些变化.

研究的目的:

评估外科技术和NAT对LADRC患者的临床,病理和长期瘤结果的影响.
评估一个单一的外科医生如何与这些进步保持一致.
分析23年时间的结果.

主要方法:

在接受NAT的561名LADRC患者的回顾性队列研究 (2001-2024年).
分为两组:第一组 (2001-2012) 和第二组 (2013-2024).
第二组采用了机器人手术,3T MRI和观察和等待 (W&W) 策略.

主要成果:

第二组患者的5年和10年无病存活率 (DFS) (p=0. 003, p=0. 006) 和整体存活率 (OS) (p<0. 001) 显著改善.
永久性无口腔存活率 (PSFS) 从I组的56. 5%显著提高到II组的85. 8% (p< 0. 001).
虽然局部复发率和远程转移率在II组呈现改善趋势,但它们没有达到统计学意义 (p=0. 107,p=0. 178).

结论:

机器人手术,高分辨率MRI和W&W策略的整合显著提高了LADRC的瘤结果.
这些进展改善了长期存活率和关节的保存率.
这项研究强调了采用现代手术技术和治疗策略对LADRC的好处.

关键词:

新辅助化学辐射治疗结直肠瘤机器人手术保护神经

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