RECTAL CANCER

被引:28
作者
McCourt, M. [2 ]
Armitage, J. [2 ]
Monson, J. R. T. [1 ]
机构
[1] Univ Rochester, Med Ctr, Div Colorectal Surg, Dept Surg, Rochester, NY 14642 USA
[2] Castle Hill Hosp, Acad Surg Unit, Cottingham, E Yorks, England
来源
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND | 2009年 / 7卷 / 03期
关键词
RECTAL CANCER; PRE-OPERATIVE STAGING; ADJUVANT THERAPY; LOCAL EXCISION; TRANSANAL ENDOSCOPIC MICROSURGERY; TOTAL MESORECTAL EXCISION; POSTOPERATIVE ADJUVANT CHEMOTHERAPY; COMBINED-MODALITY THERAPY; LOW ANTERIOR RESECTION; LOCAL EXCISION; RADIATION-THERAPY; TRANSRECTAL ULTRASONOGRAPHY; RADICAL RESECTION; TUMOR MORPHOLOGY;
D O I
10.1016/S1479-666X(09)80040-1
中图分类号
R61 [外科手术学];
学科分类号
100210 [外科学];
摘要
Surgery is the cornerstone of rectal cancer treatment. Oncological cure and overall survival continue to be the main goals, but sparing of the anal sphincter mechanism and functional results are also important. The modern management of rectal cancer is a multidisciplinary approach, and pre-operative staging is of crucial importance when planning treatment in these patients. Pre-operative staging is used to determine the indication for neoadjuvant therapy prior to surgical resection or to determine whether local excision is an option in carefully selected patients with early rectal cancer. Surgery in the form of total mesorectal excision (TME) has become the standard of care for mid and distal rectal cancers. Early rectal cancers do not require neoadjuvant therapy. For locally advanced cancers of the lower two-thirds of the rectum, the combination of surgical resection with chemoradiotherapy decreases local recurrence rates and probably improves overall survival. Whereas in the past local excision was only contemplated in patients who were unfit for radical surgery or for local palliation in cases of metastatic disease, over the last number of years there has been increasing interest in local treatment with curative intent in early rectal cancer.
引用
收藏
页码:162 / 169
页数:8
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