MSS直肠癌症的器官保存。

IF 1.2 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-16 eCollection Date: 2023-11-01 DOI:10.1055/s-0043-1767710
Yuye Gao, Aiwen Wu
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引用次数: 0

摘要

癌症是一种异质性疾病,具有复杂的遗传和分子亚型。新辅助治疗的新进展导致微卫星稳定型(MSS)直肠癌症的病理和临床完全反应(cCR)率增加,该癌仅对免疫检查点抑制剂反应较差。因此,保留MSS直肠癌症的器官作为根治性手术的替代方案已逐渐成为可行的选择。对于新辅助治疗后的cCR或接近cCR的患者,可以安全地进行器官保存,发病率较低。患者选择可以在新辅助治疗之前进行,以获得更高的概率,也可以在仔细评估后进行,以取得良好的结果。那些取得良好临床反应的患者通过非手术治疗、器官保存手术或单独放射治疗进行管理,然后进行严格的监测。与根治性手术相比,精心选择和保存器官的患者的肿瘤学结果似乎并不差,术后发病率较低。然而,还需要做更多的研究来寻求更好的肿瘤消退,并最大限度地提高MSS直肠癌患者器官保存的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Organ Preservation in MSS Rectal Cancer.

Rectal cancer is a heterogeneous disease with complex genetic and molecular subtypes. Emerging progress of neoadjuvant therapy has led to increased pathological and clinical complete response (cCR) rates for microsatellite stable (MSS) rectal cancer, which responds poorly to immune checkpoint inhibitor alone. As a result, organ preservation of MSS rectal cancer as an alternative to radical surgery has gradually become a feasible option. For patients with cCR or near-cCR after neoadjuvant treatment, organ preservation can be implemented safely with less morbidity. Patient selection can be done either before the neoadjuvant treatment for higher probability or after with careful assessment for a favorable outcome. Those patients who achieved a good clinical response are managed with nonoperative management, organ preservation surgery, or radiation therapy alone followed by strict surveillance. The oncological outcomes of patients with careful selection and organ preservation seem to be noninferior compared with those of radical surgery, with lower postoperative morbidity. However, more studies should be done to seek better regression of tumor and maximize the possibility of organ preservation in MSS rectal cancer.

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来源期刊
Clinics in Colon and Rectal Surgery
Clinics in Colon and Rectal Surgery GASTROENTEROLOGY & HEPATOLOGYSURGERY-SURGERY
CiteScore
2.60
自引率
7.10%
发文量
84
期刊介绍: Clinics in Colon and Rectal Surgery is a review journal that publishes topic-specific issues on diseases of the small bowel, colon, rectum, and anus. Designed for clinicians, researchers, and educators involved with diseases of the intestinal tract, the journal covers a broad spectrum of basic information, controversial clinical issues, and established and innovative diagnostic techniques. Issue topics comprehensively cover the entire specialty over a 3-4 year period, allowing the articles to serve as study material for educational programs and certifying examinations. The inclusion of research and clinical material also allows physicians to remain knowledgeable of current advances in the specialty.
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