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首页> 外文期刊>Acta oncologica. >Local excision for more advanced rectal tumors.
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Local excision for more advanced rectal tumors.

机译：局部切除可治疗更晚期的直肠肿瘤。

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Over the past 20 years, local excision (LE) of T1 rectal cancer was increasingly established and represents an oncologically established technique. In contrast, the situation for T2 tumors is less clear and has only been investigated in small patient collectives. LE for T2 tumors is thus discussed controversially. MATERIALS AND METHODS: In addition to our own patients with T2 rectal cancer treated locally (n=40), we have analysed the local recurrence (LR) rates after LE alone (n=124), after immediate conventional radical reoperation (n=29), after adjuvant (chemo)-radiotherapy (n=294) and those after neoadjuvant chemoradiotherapy (nCRT) (n=269) using a PubMed search. RESULTS: LR rates of low-grade T2 tumors after R0 resection by LE alone was 19%. If additional prognostically unfavorable findings were present, the LR rate rose to 52%. By immediate radical reoperation the LR rate was decreased to 7%, whereas that after adjuvant therapy was 16%. In contrast, LE of more advanced tumors after nCRT resulted in LR rates of 9%. DISCUSSION: LE alone of T2 rectal cancer should not be performed, and after adjuvant chemoradiotherapy the risk of developing LR was also high. In cases with unexpected T2 finding after LE, immediate conventional reoperation can represent an adequate oncological therapy, because it reveals comparable results to those obtained by primary radical resection. First results after nCRT followed by LE showed favorable results with low LR rates. If the indication for LE of T2 cancers can be extended to patients after nCRT in the future will have to be determined in prospective mutlticentre studies.
机译：在过去的20年中，T1直肠癌的局部切除（LE）越来越多，并且代表了肿瘤学上已建立的技术。相比之下，T2肿瘤的情况尚不清楚，仅在小型患者集体中进行过调查。因此，关于T2肿瘤的LE有争议。材料与方法：除了我们自己的局部治疗的T2直肠癌患者（n = 40），我们还分析了立即进行常规根治性再次手术（n = 29）单独进行LE后（n = 124）的局部复发率（LR） ），放疗后（n = 294）和新放化疗（nCRT）后（n = 269），使用PubMed搜索。结果：仅靠LE切除R0后，低度T2肿瘤的LR率为19％。如果存在其他在预后方面不利的发现，则LR率上升至52％。通过立即的彻底再手术，LR率降低至7％，而辅助治疗后的LR率为16％。相反，nCRT后更晚期肿瘤的LE导致LR率为9％。讨论：不应单独进行T2直肠癌的LE治疗，并且在辅助放化疗后发生LR的风险也很高。如果在LE后发现意外的T2征象，立即进行常规再手术就可以代表一种充分的肿瘤治疗方法，因为它显示出与通过原发性根治性切除术获得的结果相当的结果。 nCRT后接着LE的最初结果显示低LR率的良好结果。如果将来在进行nCRT之后可以将T2癌的LE适应症扩展到患者，则必须在前瞻性多态性研究中确定。

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