医学
全直肠系膜切除术
结直肠癌
新辅助治疗
外科
癌症
疾病
临床试验
普通外科
内科学
乳腺癌
摘要
Abstract Nonoperative treatment of rectal cancer is gaining popularity. Several trials recently demonstrated advantages in disease‐free survival with total neoadjuvant treatment (TNT) with the addition of the watch and wait (WW) strategy for locally advanced rectal cancer. On longer follow‐up, an unexpected increased risk in local recurrence in the TNT group at the RAPIDO trial suggested early surgery for nonresponding tumours. The WW option is globally accepted for a complete clinical response; however, a high rate of regrowth was found in a registry with an increased risk of distant metastases, questioning the deleterious effect of deferral of surgery in this group. The short‐ and long‐term toxic effects of neoadjuvant treatment are costs to consider in the National Comprehensive Cancer Network guidelines compared with the European Society for Medical Oncology guidelines, which favour surgery alone if good mesorectal resection is assured with increasing surgical proficiency adjusted to the precise anatomical location.
科研通智能强力驱动
Strongly Powered by AbleSci AI