Controversial aspects of rectal cancer surgery following preoperative chemoradiation

被引:4
作者
Artioukh, D. Y. [1 ]
机构
[1] Southport & Ormskirk Hosp, Dept Surg, Southport PR8 6PN, Merseyside, England
关键词
Rectal adenocarcinoma; surgery; preoperative chemoradiotherapy; PATHOLOGICAL COMPLETE RESPONSE; COMBINED-MODALITY THERAPY; TOTAL MESORECTAL EXCISION; LOCAL RECURRENCE; ABDOMINOPERINEAL EXCISION; SPHINCTER PRESERVATION; TUMOR-REGRESSION; RADIOTHERAPY; CHEMORADIOTHERAPY; INVOLVEMENT;
D O I
10.1111/j.1463-1318.2010.02321.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The role of surgery in the loco-regional control of adenocarcinoma of the rectum is being increasingly challenged by the good response rates of neoadjuvant oncological treatment. This review represents an opinion paper outlining well-established choices and new trends in surgical intervention, unresolved difficulties of local and regional staging of rectal malignancy and accurate assessment of tumour response to preoperative downstaging chemoradiation. The influence of preoperative chemoradiation on subsequent surgical strategy is discussed highlighting several controversial aspects of surgical management both when the tumour fails to respond and appears to be irresectable and when complete clinical response is observed.
引用
收藏
页码:25 / 29
页数:5
相关论文
共 43 条
[1]   Risk factors for impaired healing of the perineal wound after abdominoperineal resection of rectum for carcinoma [J].
Artioukh, D. Y. ;
Smith, R. A. ;
Gokul, K. .
COLORECTAL DISEASE, 2007, 9 (04) :362-367
[2]  
*ASS GOL GREAT BRI, 2001, GUID MAN COL CANC, P2102
[3]  
*ASS GOL GREAT BRI, 2007, GUID MAN COL CANC, P2102
[4]   Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study [J].
Brown, G. ;
Daniels, I. R. ;
Heald, R. J. ;
Quirke, P. ;
Blomqvist, L. ;
Sebag-Montefiore, D. ;
Moran, B. J. ;
Holm, T. ;
Strassbourg, J. ;
Peppercorn, P. D. ;
Fisher, S. E. ;
Mason, B. .
BRITISH MEDICAL JOURNAL, 2006, 333 (7572) :779-782
[5]   Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging [J].
Brown, G ;
Radcliffe, AG ;
Newcombe, RG ;
Dallimore, NS ;
Bourne, MW ;
Williams, GT .
BRITISH JOURNAL OF SURGERY, 2003, 90 (03) :355-364
[6]   Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy [J].
Bujko, K ;
Nowacki, MP ;
Nasierowska-Guttmejer, A ;
Michalski, W ;
Bebenek, AB ;
Pudelko, M ;
Kryj, A ;
Oledzki, J ;
Szmeja, J ;
Sluszniak, J ;
Serkies, K ;
Kladny, J ;
Pamucka, A ;
Kukolowicz, P .
RADIOTHERAPY AND ONCOLOGY, 2004, 72 (01) :15-24
[7]   Preoperative radiotherapy for resectable rectal cancer -: A meta-analysis [J].
Cammà, C ;
Giunta, M ;
Fiorica, F ;
Pagliaro, L ;
Craxì, A ;
Cottone, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 284 (08) :1008-1015
[8]  
Cedermark B, 1996, ANN SURG ONCOL, V3, P423
[9]   Pathological features of rectal cancer after preoperative radiochemotherapy [J].
Dworak, O ;
Keilholz, L ;
Hoffmann, A .
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 1997, 12 (01) :19-23
[10]   Combined chemo- and radiotherapy vs. radiotherapy alone in the treatment of primary, nonresectable adenocarcinoma of the rectum [J].
Frykholm, GJ ;
Påhlman, L ;
Glimelius, B .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2001, 50 (02) :427-434