局部晚期直肠癌新辅助化疗放疗后的观察和等待方法:一项回顾性单中心队列研究。

IF 2 3区 医学 Q3 ONCOLOGY Journal of Surgical Oncology Pub Date : 2024-11-14 DOI:10.1002/jso.28001
Georgi Kalev, Sylvia Buettner, Tianzuo Zhan, Ralf-Dieter Hofheinz, Judit Boda-Heggemann, Christoph Reissfelder, Steffen Seyfried, Georgi Vassilev, Julia Hardt
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引用次数: 0

摘要

背景和目的:对局部晚期直肠癌(LARC)化疗后完全临床反应(cCR)的患者采取观察和等待(WW)策略,可选择保留器官。本研究旨在评估在德国一家癌症转诊中心接受治疗和随访的观察等待策略患者的肿瘤治疗效果:在这项回顾性研究中,我们分析了 2020 年 1 月至 2023 年 12 月期间在我院接受新辅助放疗/化疗的连续 LARC 患者的临床记录,这些患者在接受 cCR 后接受了非手术治疗:结果:共纳入30例接受WW治疗的LARC患者。中位随访 17 个月(SD = 10 个月)后,4 例患者(4/30,13.3%)出现局部生长,1 例患者(1/30,3.3%)出现远处转移。根据诊断时的放射学结果,包括cT4和/或cN2、直肠系膜筋膜受累、壁外血管侵犯或肛门括约肌/提肛肌浸润等,无法确定肿瘤再生的预测因素。所有局部再生的患者都成功接受了手术治疗(R0切除):结论:事实证明,对LARC新辅助治疗后出现cCR的患者进行非手术治疗是安全的。所有接受挽救手术的患者都成功实现了R0切除。
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Watch-and-Wait Approach Following Neoadjuvant Chemo-Radiotherapy for Locally Advanced Rectal Cancer: A Retrospective Single-Center Cohort Study.

Background and objectives: The watch-and-wait (WW) strategy in patients after complete clinical response (cCR) following chemoradiotherapy for locally advanced rectal cancer (LARC) offers the option of organ preservation. The aim of this study was to assess the oncological outcomes of WW patients treated and followed up in a German referral cancer center.

Methods: In this retrospective study, we analyzed the clinical records of consecutive patients with LARC who underwent neoadjuvant radiotherapy/chemoradiotherapy at our institution between January 2020 and December 2023 and received non-operative management after cCR.

Results: A total of 30 patients undergoing WW for LARC were included. After a median follow-up of 17 months (SD = 10 months), local regrowth occurred in four patients (4/30, 13.3%), and one patient (1/30, 3.3%) developed distant metastasis. No predictor for tumor regrowth could be identified based on radiological findings at diagnosis, including cT4 and/or cN2, involvement of the mesorectal fascia, extramural vascular invasion or infiltration of the anal sphincter/levator. All patients with local regrowth were successfully surgically treated (R0 resection).

Conclusion: Nonoperative management for patients with cCR after neoadjuvant therapy for LARC proved to be safe. R0 resection was successfully achieved in all patients who underwent salvage surgery.

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来源期刊
CiteScore
4.70
自引率
4.00%
发文量
367
审稿时长
2 months
期刊介绍: The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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