Pub Date : 2025-03-04DOI: 10.1097/DCR.0000000000003690
James A Pasch, Wendy Liu, Shahrir Kabir, Thomas Pennington
Background: Whilst revolutionary in cutaneous melanoma, immune checkpoint inhibitors have shown reduced efficacy in anorectal melanoma. Nevertheless, their emergence, and the possibility of improved outcomes, may have changed the surgical management paradigm.
Objective: To review the surgical management of anorectal melanoma in pre- and post-immunotherapy eras.
Design: A retrospective cohort study from the Melanoma Institute Australia Research Database.
Settings: A quaternary melanoma referral center.
Patients: Patients with anorectal melanoma from 1958 to 2021.
Interventions: The use of abdominoperineal resection and wide local excision were compared in pre- and post-immunotherapy eras from first use in 2014.
Main outcome measures: Type of surgery performed over time and overall survival.
Results: A total of 56 patients were identified with anal (57.1%), anorectal (16.1%) and rectal melanoma (26.8%). Initial management was abdominoperineal resection (37.5%), low anterior resection (3.6%), wide local excision (46.4%) and non-surgical (12.5%) in metastatic or unresectable disease. Immunotherapy and targeted therapies were utilized in 21 patients (37.5%) from 2014 with no difference in mode of surgical management in pre- and post-immunotherapy eras (p = 0.134). Five-year survival was 12.5% for the entire cohort with no significant difference comparing patients receiving wide local excision or abdominoperineal resection (15.4% vs. 14.3%, log rank p = 0.77). Involved margins were significantly associated with wide local excision (15.4% vs. 4.8% p = 0.016) with similar rates of local recurrence (15.4% vs. 14.3% p = 0.58).
Limitations: Anorectal melanoma is rare thus we present a small cohort managed across eight decades. Early checkpoint inhibitor trials excluded mucosal melanoma patients, limiting access in this cohort.
Conclusions: Despite the introduction of immunotherapy, surgery remains pivotal in the management of anorectal melanoma. Surgical resection may be curative and prevent morbidity due to locoregional progression but can come at a cost of reduced quality of life. Centralized management in experienced centers should be encouraged for optimal multi-disciplinary management. See Video Abstract.
{"title":"Approaches to Surgical Management of Anorectal Melanoma in the Pre- and Post-Immunotherapy Eras.","authors":"James A Pasch, Wendy Liu, Shahrir Kabir, Thomas Pennington","doi":"10.1097/DCR.0000000000003690","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003690","url":null,"abstract":"<p><strong>Background: </strong>Whilst revolutionary in cutaneous melanoma, immune checkpoint inhibitors have shown reduced efficacy in anorectal melanoma. Nevertheless, their emergence, and the possibility of improved outcomes, may have changed the surgical management paradigm.</p><p><strong>Objective: </strong>To review the surgical management of anorectal melanoma in pre- and post-immunotherapy eras.</p><p><strong>Design: </strong>A retrospective cohort study from the Melanoma Institute Australia Research Database.</p><p><strong>Settings: </strong>A quaternary melanoma referral center.</p><p><strong>Patients: </strong>Patients with anorectal melanoma from 1958 to 2021.</p><p><strong>Interventions: </strong>The use of abdominoperineal resection and wide local excision were compared in pre- and post-immunotherapy eras from first use in 2014.</p><p><strong>Main outcome measures: </strong>Type of surgery performed over time and overall survival.</p><p><strong>Results: </strong>A total of 56 patients were identified with anal (57.1%), anorectal (16.1%) and rectal melanoma (26.8%). Initial management was abdominoperineal resection (37.5%), low anterior resection (3.6%), wide local excision (46.4%) and non-surgical (12.5%) in metastatic or unresectable disease. Immunotherapy and targeted therapies were utilized in 21 patients (37.5%) from 2014 with no difference in mode of surgical management in pre- and post-immunotherapy eras (p = 0.134). Five-year survival was 12.5% for the entire cohort with no significant difference comparing patients receiving wide local excision or abdominoperineal resection (15.4% vs. 14.3%, log rank p = 0.77). Involved margins were significantly associated with wide local excision (15.4% vs. 4.8% p = 0.016) with similar rates of local recurrence (15.4% vs. 14.3% p = 0.58).</p><p><strong>Limitations: </strong>Anorectal melanoma is rare thus we present a small cohort managed across eight decades. Early checkpoint inhibitor trials excluded mucosal melanoma patients, limiting access in this cohort.</p><p><strong>Conclusions: </strong>Despite the introduction of immunotherapy, surgery remains pivotal in the management of anorectal melanoma. Surgical resection may be curative and prevent morbidity due to locoregional progression but can come at a cost of reduced quality of life. Centralized management in experienced centers should be encouraged for optimal multi-disciplinary management. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-03DOI: 10.1097/DCR.0000000000003714
Serena Perotti, Michela Mineccia, Paolo Massucco, Federica Gonella, A Ferrero
{"title":"Reply.","authors":"Serena Perotti, Michela Mineccia, Paolo Massucco, Federica Gonella, A Ferrero","doi":"10.1097/DCR.0000000000003714","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003714","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Background: </strong>The preservation of the pelvic autonomic nervous system in total mesorectal excision remains challenging to date. The application of laparoscopy has enabled visualization of fine anatomical structures; however, the rate of urogenital dysfunction remains high.</p><p><strong>Objective: </strong>To establish an artificial intelligence neurorecognition system to perform neurorecognition during total mesorectal excision.</p><p><strong>Design: </strong>This is a retrospective study.</p><p><strong>Setting: </strong>The study was conducted at a single hospital.</p><p><strong>Patients: </strong>Intraoperative images or video screenshots of patients with rectal cancer admitted to the Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, between January 2016 and December 2023, were retrospectively collected.</p><p><strong>Main outcome measure: </strong>Mean intersection over union, precision, recall, and F1 of the model.</p><p><strong>Results: </strong>A total of 1424 high-quality intraoperative images were included in the training group. The proposed model was obtained after 700 iterations. The mean intersection over union was 0.75, and it slowly increased with an increase in training time. The precision and recall of the nerve category were 0.7494 and 0.6587, respectively, and the F1 was 0.7011. The video prediction shows that the model achieves a high accuracy rate, which could facilitate effective neurorecognition.</p><p><strong>Limitation: </strong>This was a single-center study.</p><p><strong>Conclusions: </strong>The artificial intelligence model for real-time visual neurorecognition in total mesorectal excision was successfully established for the first time in China. Better identification of these autonomic nerves should allow for better preservation of urogenital function, but further research is needed to validate this claim. See Video Abstract .</p><p><strong>Sistema de reconocimiento con inteligencia artificial del nervio autnomo plvico durante la escisin total del mesorrectal: </strong>ANTECEDENTES:La preservación del sistema nervioso autónomo pélvico en la escisión mesorrectal total sigue siendo un desafío hasta la fecha. La aplicación de la laparoscopia ha permitido la visualización de estructuras anatómicas finas; sin embargo, la tasa de disfunción urogenital sigue siendo alta.OBJETIVO:Establecer un sistema de reconocimiento neurológico con inteligencia artificial para realizar el reconocimiento neurológico durante la escisión mesorrectal total.DISEÑO Y ESCENARIO:Este estudio retrospectivo se realizó en un solo hospital.PACIENTES:Se recopilaron retrospectivamente imágenes intraoperatorias o capturas de pantalla de video de pacientes con cáncer de recto ingresados en el Departamento de Cirugía Gastrointestinal, del Hospital Memorial Sun Yat-sen, de la Universidad Sun Yat-sen, entre enero de 2016 y diciembre de 2023.PRINCIPALES MEDIDAS DE VALORACIÓN:Intersección media so
{"title":"Artificial Intelligence Recognition System of Pelvic Autonomic Nerve During Total Mesorectal Excision.","authors":"Fanghai Han, Guangyu Zhong, Shilin Zhi, Naiqian Han, Yongjun Jiang, Jia'nan Tan, Lin Zhong, Shengning Zhou","doi":"10.1097/DCR.0000000000003547","DOIUrl":"10.1097/DCR.0000000000003547","url":null,"abstract":"<p><strong>Background: </strong>The preservation of the pelvic autonomic nervous system in total mesorectal excision remains challenging to date. The application of laparoscopy has enabled visualization of fine anatomical structures; however, the rate of urogenital dysfunction remains high.</p><p><strong>Objective: </strong>To establish an artificial intelligence neurorecognition system to perform neurorecognition during total mesorectal excision.</p><p><strong>Design: </strong>This is a retrospective study.</p><p><strong>Setting: </strong>The study was conducted at a single hospital.</p><p><strong>Patients: </strong>Intraoperative images or video screenshots of patients with rectal cancer admitted to the Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, between January 2016 and December 2023, were retrospectively collected.</p><p><strong>Main outcome measure: </strong>Mean intersection over union, precision, recall, and F1 of the model.</p><p><strong>Results: </strong>A total of 1424 high-quality intraoperative images were included in the training group. The proposed model was obtained after 700 iterations. The mean intersection over union was 0.75, and it slowly increased with an increase in training time. The precision and recall of the nerve category were 0.7494 and 0.6587, respectively, and the F1 was 0.7011. The video prediction shows that the model achieves a high accuracy rate, which could facilitate effective neurorecognition.</p><p><strong>Limitation: </strong>This was a single-center study.</p><p><strong>Conclusions: </strong>The artificial intelligence model for real-time visual neurorecognition in total mesorectal excision was successfully established for the first time in China. Better identification of these autonomic nerves should allow for better preservation of urogenital function, but further research is needed to validate this claim. See Video Abstract .</p><p><strong>Sistema de reconocimiento con inteligencia artificial del nervio autnomo plvico durante la escisin total del mesorrectal: </strong>ANTECEDENTES:La preservación del sistema nervioso autónomo pélvico en la escisión mesorrectal total sigue siendo un desafío hasta la fecha. La aplicación de la laparoscopia ha permitido la visualización de estructuras anatómicas finas; sin embargo, la tasa de disfunción urogenital sigue siendo alta.OBJETIVO:Establecer un sistema de reconocimiento neurológico con inteligencia artificial para realizar el reconocimiento neurológico durante la escisión mesorrectal total.DISEÑO Y ESCENARIO:Este estudio retrospectivo se realizó en un solo hospital.PACIENTES:Se recopilaron retrospectivamente imágenes intraoperatorias o capturas de pantalla de video de pacientes con cáncer de recto ingresados en el Departamento de Cirugía Gastrointestinal, del Hospital Memorial Sun Yat-sen, de la Universidad Sun Yat-sen, entre enero de 2016 y diciembre de 2023.PRINCIPALES MEDIDAS DE VALORACIÓN:Intersección media so","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"308-315"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-10DOI: 10.1097/DCR.0000000000003396
Ankit Sharma, Yogesh Bansod, Avanish Saklani
{"title":"Robotic Low Anterior Resection With En Bloc Total Abdominal Hysterectomy With Bilateral Salpingo-oophorectomy.","authors":"Ankit Sharma, Yogesh Bansod, Avanish Saklani","doi":"10.1097/DCR.0000000000003396","DOIUrl":"10.1097/DCR.0000000000003396","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e103"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-03DOI: 10.1097/DCR.0000000000003618
Alexandra N Jones, Hillary L Simon
{"title":"Sexual Dysfunction After Pelvic Radiotherapy.","authors":"Alexandra N Jones, Hillary L Simon","doi":"10.1097/DCR.0000000000003618","DOIUrl":"10.1097/DCR.0000000000003618","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"267-270"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-12DOI: 10.1097/DCR.0000000000003622
Larissa K F Temple
{"title":"Expert Commentary on Sexual Function Following Radiation for Rectal Cancer.","authors":"Larissa K F Temple","doi":"10.1097/DCR.0000000000003622","DOIUrl":"10.1097/DCR.0000000000003622","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"270-271"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Salvage Laparoscopic Left Lateral Lymph Node Dissection for Regrowth Without Total Mesorectal Excision 30 Months After Completion of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer.","authors":"Ryutaro Kobayashi, Atsushi Ogura, Yuki Murata, Takanori Jinno, Konosuke Yogo, Koji Fukata, Takashi Mizuno, Tomoki Ebata","doi":"10.1097/DCR.0000000000003584","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003584","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 3","pages":"e102"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-11-18DOI: 10.1097/DCR.0000000000003538
Roni Y Rosen, Aron P Bercz, Dana M Omer, Floris S Verheij, Hannah Williams, Parisa Malekzadeh, Danielle L Kong, Felipe F Quezada-Diaz, Iris H Wei, Maria Widmar, Georgios Karagkounis, Diana Roth O'Brien, Carla Hajj, Christopher H Crane, Ping Gu, Neil H Segal, Marina Shcherba, Karuna Ganesh, Rona Yaeger, Emmanouil Pappou, Paul B Romesser, Garrett M Nash, Leonard B Saltz, Andrea Cercek, Martin R Weiser, Mithat Gönen, Philip B Paty, Julio Garcia-Aguilar, J Joshua Smith
<p><strong>Background: </strong>The watch-and-wait strategy provides an opportunity to pursue nonoperative management in rectal cancer patients with clinical complete response after neoadjuvant therapy. The management of those with near-complete response remains controversial.</p><p><strong>Objective: </strong>We assessed the oncologic outcomes of patients managed by watch-and-wait versus total mesorectal excision according to clinical response to neoadjuvant therapy.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Comprehensive cancer center in New York.</p><p><strong>Patients: </strong>Patients with rectal adenocarcinoma diagnosed between January 2006 and December 2020.</p><p><strong>Interventions: </strong>A watch-and-wait strategy of active surveillance was offered to patients if they achieved clinical complete response. Salvage surgery was used for watch-and-wait patients with local regrowth. Patients with an incomplete response underwent total mesorectal excision.</p><p><strong>Main outcome measures: </strong>Local regrowth rate, organ preservation rate, disease-free survival, and overall survival.</p><p><strong>Results: </strong>Patients with rectal adenocarcinoma (n = 1230) were divided into 3 response cohorts-incomplete (n = 646), near-complete (n = 189), and complete (n = 395). Eighty-one patients (43%) in the near-complete group and 351 patients (89%) in the complete group entered watch-and-wait. Three-year local regrowth rates were 40% and 24% in the near-complete and complete response cohorts, respectively. The 5-year organ preservation rate was 53% in near-complete responders and 73% in complete responders. Five-year disease-free survival increased with greater clinical response to neoadjuvant therapy, with intermediate outcomes noted for patients with a near-complete (73%) compared to complete (82%) or incomplete (68%) response. Overall survival at 5 years was similar between the 3 cohorts (complete 90%, near-complete 86%, and incomplete 85%).</p><p><strong>Limitations: </strong>Retrospective nature.</p><p><strong>Conclusions: </strong>Greater clinical response to neoadjuvant therapy is associated with improved oncologic outcomes. Near-complete responders may avoid surgery and still achieve high organ preservation rates yet experience greater local regrowth rates than clinical complete response patients. Ongoing prospective trials integrating watch-and-wait after complete response as determined by uniform criteria will bolster the work to help treating physicians better select patients who qualify for active surveillance. See Video Abstract .</p><p><strong>Correlacin entre el grado de respuesta clnica a la terapia neoadyuvante contra el cncer del recto y los resultados oncolgicos en la era de observar y esperar: </strong>ANTECEDENTES:La estrategia de observar y esperar brinda la oportunidad de buscar un tratamiento no quirúrgico en pacientes con cáncer del recto con respuesta clínica comp
{"title":"Correlation Between Grade of Clinical Response to Neoadjuvant Therapy for Rectal Cancer and Oncologic Outcomes in the Era of Watch-and-Wait.","authors":"Roni Y Rosen, Aron P Bercz, Dana M Omer, Floris S Verheij, Hannah Williams, Parisa Malekzadeh, Danielle L Kong, Felipe F Quezada-Diaz, Iris H Wei, Maria Widmar, Georgios Karagkounis, Diana Roth O'Brien, Carla Hajj, Christopher H Crane, Ping Gu, Neil H Segal, Marina Shcherba, Karuna Ganesh, Rona Yaeger, Emmanouil Pappou, Paul B Romesser, Garrett M Nash, Leonard B Saltz, Andrea Cercek, Martin R Weiser, Mithat Gönen, Philip B Paty, Julio Garcia-Aguilar, J Joshua Smith","doi":"10.1097/DCR.0000000000003538","DOIUrl":"10.1097/DCR.0000000000003538","url":null,"abstract":"<p><strong>Background: </strong>The watch-and-wait strategy provides an opportunity to pursue nonoperative management in rectal cancer patients with clinical complete response after neoadjuvant therapy. The management of those with near-complete response remains controversial.</p><p><strong>Objective: </strong>We assessed the oncologic outcomes of patients managed by watch-and-wait versus total mesorectal excision according to clinical response to neoadjuvant therapy.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Comprehensive cancer center in New York.</p><p><strong>Patients: </strong>Patients with rectal adenocarcinoma diagnosed between January 2006 and December 2020.</p><p><strong>Interventions: </strong>A watch-and-wait strategy of active surveillance was offered to patients if they achieved clinical complete response. Salvage surgery was used for watch-and-wait patients with local regrowth. Patients with an incomplete response underwent total mesorectal excision.</p><p><strong>Main outcome measures: </strong>Local regrowth rate, organ preservation rate, disease-free survival, and overall survival.</p><p><strong>Results: </strong>Patients with rectal adenocarcinoma (n = 1230) were divided into 3 response cohorts-incomplete (n = 646), near-complete (n = 189), and complete (n = 395). Eighty-one patients (43%) in the near-complete group and 351 patients (89%) in the complete group entered watch-and-wait. Three-year local regrowth rates were 40% and 24% in the near-complete and complete response cohorts, respectively. The 5-year organ preservation rate was 53% in near-complete responders and 73% in complete responders. Five-year disease-free survival increased with greater clinical response to neoadjuvant therapy, with intermediate outcomes noted for patients with a near-complete (73%) compared to complete (82%) or incomplete (68%) response. Overall survival at 5 years was similar between the 3 cohorts (complete 90%, near-complete 86%, and incomplete 85%).</p><p><strong>Limitations: </strong>Retrospective nature.</p><p><strong>Conclusions: </strong>Greater clinical response to neoadjuvant therapy is associated with improved oncologic outcomes. Near-complete responders may avoid surgery and still achieve high organ preservation rates yet experience greater local regrowth rates than clinical complete response patients. Ongoing prospective trials integrating watch-and-wait after complete response as determined by uniform criteria will bolster the work to help treating physicians better select patients who qualify for active surveillance. See Video Abstract .</p><p><strong>Correlacin entre el grado de respuesta clnica a la terapia neoadyuvante contra el cncer del recto y los resultados oncolgicos en la era de observar y esperar: </strong>ANTECEDENTES:La estrategia de observar y esperar brinda la oportunidad de buscar un tratamiento no quirúrgico en pacientes con cáncer del recto con respuesta clínica comp","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"300-307"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-06DOI: 10.1097/DCR.0000000000003444
Marco Bertucci Zoccali, Cintia Mayumi Sakurai Kimura, Brandon C Chapman, Tamzin Cuming, Carmen F Fong, Naomi Jay, Jennifer A Kaplan, Michelle J Khan, Craig A Messick, Vlad V Simianu, Jeremy J Sugrue, Luis F Barroso
{"title":"Management of Anal Dysplasia: A Pragmatic Summary of the Current Evidence and Definition of Clinical Practices for Prevention, Diagnosis, and Treatment.","authors":"Marco Bertucci Zoccali, Cintia Mayumi Sakurai Kimura, Brandon C Chapman, Tamzin Cuming, Carmen F Fong, Naomi Jay, Jennifer A Kaplan, Michelle J Khan, Craig A Messick, Vlad V Simianu, Jeremy J Sugrue, Luis F Barroso","doi":"10.1097/DCR.0000000000003444","DOIUrl":"10.1097/DCR.0000000000003444","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"272-286"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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