Multidisciplinary treatment strategy for early rectal cancer: A review

Precision and Future Medicine

Sang Bo Oh¹  Hyung Wook Kim²  Su Bum Park²  Dong Hoon Shin³  Tae Un Kim⁴  Gyung Mo Son⁵  Byung-Soo Park⁵  Hyun Sung Kim⁵  Sung Hwan Cho⁵  In Young Lee⁵ 

[1] Department of Hemato-oncology, Pusan National University Yangsan Hospital, Yangsan, Korea;Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea;Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea;Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea;Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea;

关键词: colonoscopy;    neoadjuvant therapy;    organ preservation;    rectal neoplasms;    transanal endoscopic surgery;   

DOI  :  10.23838/pfm.2021.00163

来源: DOAJ

【 摘 要 】

The early rectal cancer (ERC) has increased with the national cancer screening project for early detection of colorectal cancer. The gold standard treatment for low rectal cancer is low anterior resection (LAR) based on total mesorectal excision. However, radical resection results in a high mortality and complication rate, and the deterioration of quality of life due to LAR syndrome, genitourinary dysfunction, and possible permanent stoma. Local excision with chemoradiation therapy could be one of the alternative therapeutic strategies for the organ preservation and a cure of cancer. To decide the treatment strategies, it is important to establish sophisticated indications that can maximize the therapeutic effect. ERC has heterogeneous pathological features, including aggressive behavior and occult lymph node metastasis, with different responses to chemoradiotherapy. Therefore, radiologic, endoscopic and pathologic evaluation to predict the risk of lymph node metastasis and local recurrence has been evolving to determine the optimal treatment strategy in the patient-tailored medicine. Recently, the long-term outcomes of prospective randomized clinical trials provide new hope for organ preservation in patients with ERC. In this paper, we aim to review various risk factors related to local recurrence and discuss the optimal treatment strategy for ERC.

【 授权许可】

Unknown