当前直肠癌治疗的策略
直肠癌;全直肠系膜切除;化学治疗;放射治疗;化学药物;局部复发;疗效,郁宝铭,通讯作者:,Currentstrategiesintreatmentofrectalcancer,Bao-MingYu,Correspondenceto:,Received:,Revised:,A
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郁宝铭, 上海交通大学医学院附属瑞金医院外科 上海市 200025
郁宝铭, 1956年毕业于上海第二医学院医疗系, 教授, 主要从事普外科兼肛肠外科研究.
通讯作者: 郁宝铭, 200025, 上海市漕宝路8号, 上海交通大学医学院附属瑞金医院外科. baomingiok@163.com
电话: 021-64514139 传真: 021-64514139
收稿日期: 2007-05-14 修回日期: 2007-07-21
Current strategies in treatment of rectal cancer
Bao-Ming Yu
Bao-Ming Yu, Department of Surgery, Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai 200025, China
Correspondence to: Bao-Ming Yu, Department of Surgery, Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University, 8 Caobao Road, Shanghai 200025, China. baomingiok@163.com
Received: 2007-05-14 Revised: 2007-07-21
Abstract
Surgical treatment is still the first choice of management for patients with rectal cancer, but the results were unsatisfied. The difficulties in treatment of rectal cancer are high local recurrence, poor postoperative life quality and low long term survival. First of all, reduction of local recurrence should be our goal and introduction of total mesorectal excision (TME) has significantly improved the outcomes following the curative resection hence the local recurrence rate has reduced to less than 10% and 5-year survival rate has been achieved to 78%. Meanwhile, the sphincter preservation resection has been increased to 70% and become the first choice of procedures in rectal cancer surgery. On the other hand, postoperative genitourinary function has also been improved significantly, so the postoperative quality of life in patients with rectal cancer is now much better than before. Application of neoadjuvant chemoradiation has further improved the surgical and oncological results in patients with locally advanced low rectal cancer (T3 and T4 stage) when combined with TME technique. Advances of systemic therapy with new chemotherapeutic agents have been proved to further improve disease-free survival and overall survival in patients with stage Ⅲ colorectal cancer ......
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