Nonoperative Management of Rectal Cancer The Watch and Wait Strategy

被引：21

作者：

Vailati, Bruna Borba ^{[1
,2
,3
,5
]}

Sao Juliao, Guilherme Pagin ^{[1
,2
,3
,5
]}

Habr-Gama, Angelita ^{[1
,2
,4
,5
]}

Perez, Rodrigo Oliva ^{[1
,2
,3
]}

机构：

[1] Angelita & Joaquim Gama Inst, Sao Paulo, SP, Brazil

[2] Hosp Alemao Oswaldo Cruz, Sao Paulo, Brazil

[3] Hosp Beneficencia Portuguesa, Sao Paulo, Brazil

[4] Univ Sao Paulo, Sch Med, Colorectal Surg Div, Sao Paulo, Brazil

[5] Praca Amadeu Amaral 47-111, BR-01327010 Sao Paulo, SP, Brazil

来源：

SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA | 2022年 / 31卷 / 02期

关键词：

Watch & wait; Organ preservation; Rectal cancer; Neoadjuvant therapy; Clinical complete response; TRANSANAL ENDOSCOPIC MICROSURGERY; DIFFUSION-WEIGHTED MRI; NEOADJUVANT CHEMORADIATION THERAPY; CLINICAL COMPLETE RESPONDERS; TERM-FOLLOW-UP; POSTOPERATIVE CHEMORADIOTHERAPY; INTERNATIONAL WATCH; ORGAN PRESERVATION; SEQUENTIAL PET/CT; SALVAGE SURGERY;

D O I：

10.1016/j.soc.2021.11.003

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Over the past few decades, rectal cancer management has become increasingly challenging for multiple reasons. Proper imaging using dedicated magnetic resonance (MR), standardization of total mesorectal excision (TME), and incorporation of neoadjuvant treatment regimens have contributed to a significant decrease in local recurrence rates while minimizing the need for definitive stomas (therefore allowing for sphincter-preservation alternatives).(1-3) However, the observation of complete tumor response to radiation (RT) or chemoradiation (CRT) led to the proposal of organpreservation strategies with avoidance of immediate surgery and close surveillance (Watch and Wait strategy) in selected patients.4 Initially considered for a very restricted subgroup of patients, the use of more contemporary neoadjuvant treatment regimens has resulted in a higher proportion of patients achieving complete tumor regression.5 The purpose of the present article is to review the current evidence related to the selection criteria and outcomes in patients enrolled in this Watch and Wait strategy.

引用

页码：171 / 182

页数：12

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