Effect of Subsequent Surgical Treatment for Complete Response Cases after Neoadjuvant Chemoradiotherapy of Low Locally Advanced Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 田君 ^1,2 , 姚學權 ¹ , 曹勤洪 ¹ ,  陳徹 ¹ , 朱旭升 ¹ , 許哲 ¹ , 李為蘇 ¹ , 劉福坤 ¹

1. ;
2. ;

Corresponding?author：

陳徹, Email: 9429038@qq.com

Keywords：

直腸癌; 新輔助放化療; 病理完全緩解; 癌胚抗原; 全直腸系膜切除術

DOI：

10.7507/1007-9424.20140179

Video：

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目的探討低位局部進展期直腸癌新輔助放化療后完全緩解病例的進一步治療方案及效果。方法回顧性分析江蘇省中醫院腫瘤外科2008年1月至2010年5月期間行新輔助放化療后初步判斷達到病理完全緩解（pCR）的14例低位局部進展期直腸癌患者的臨床資料。結果 14例患者中接受手術者10例，術后真正達到pCR者5例；術后2例復發或轉移，其中死亡1例，1例帶瘤生存，余8例患者均無瘤生存。未行手術的4例患者中，有3例復發或轉移，其中2例死亡，1例帶瘤生存；余1例無瘤生存。4例未行手術病例中CEA水平正常者（<5 μg/L）2例（1例復發或轉移），CEA升高的2例均發生轉移；10例手術病例中CEA水平正常者6例（均無瘤生存，4例真正達到pCR），升高者4例（1例真正達到pCR，2例復發或轉移）。結論接受新輔助放化療后初步判斷達到pCR的病例，尤其是CEA值高于正常者，應接受規范的全直腸系膜切除（TME）手術以達到根治的目的。

Citation： 田君, 姚學權, 曹勤洪, 陳徹, 朱旭升, 許哲, 李為蘇, 劉福坤. Effect of Subsequent Surgical Treatment for Complete Response Cases after Neoadjuvant Chemoradiotherapy of Low Locally Advanced Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(6): 754-756. doi: 10.7507/1007-9424.20140179 Copy

1.	?Bosset JF, Collette L, Calais G, et al.Chemotherapy with preoperative radiotherapy in rectal cancer[J].N Engl J Med, 2006, 355(11):1114-1123.
2.	Greto D, Paiar F, Saieva C, et al.Neoadjuvant oxaliplatin and 5-fluorouracil with concurrent radiotherapy in patients with locally advanced rectal cancer:a single-institution experience[J].Radiol Med, 2013, 118(4):570-582.
3.	Improved survival with preoperative radiotherapy in resectable rectal cancer.Swedish Rectal Cancer Trial[J].N Engl J Med, 1997, 336(14):980-987.
4.	Kapiteijn E, Marijnen CA, Nagtegaal ID, et al.Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer[J].N Engl J Med, 2001, 345(9):638-646.
5.	Colorectal Cancer Collaborative Group.Adjuvant radiotherapy for rectal cancer:a systematic overview of 8507 patients from 22 randomised trials[J].Lancet, 2001, 358(9290):1291-1304.
6.	李世正,單吉賢,馬振海,等.直腸癌根治術前輔助放射治療隨機研究的meta分析[J].中國實用外科雜志, 2006, 26(8):598-601.
7.	Kuriu Y, Kokuba Y, Murayama Y, et al.Neoadjuvant chemoradiotherapy for locally advanced rectal cancer[J].Gan To Kagaku Ryoho, 2012, 39(12):1951-1953.
8.	Habr-Gama A, Perez RO, Nadalin W, et al.Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy:long-term results[J].Ann Surg, 2004, 240(4):711-717.
9.	Maas M, Nelemans PJ, Valentini V, et al.Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer:a pooled analysis of individual patient data[J].Lancet Oncol, 2010, 11(9):835-844.
10.	Nakagawa WT, Rossi BM, de O Ferreira F, et al.Chemoradiation instead of surgery to treat mid and low rectal tumors:is it safe?[J].Ann Surg Oncol, 2002, 9(6):568-573.
11.	Kuo LJ, Liu MC, Jian JJ, et al.Is final TNM staging a predictor for survival in locally advanced rectal cancer after preoperative chemoradiation therapy?[J].Ann Surg Oncol, 2007, 14(10):2766-2772.
12.	Heald RJ, Husband EM, Ryall RD.The mesorectum in rectal cancer surgery-the clue to pelvic recurrence?[J].Br J Surg, 1982, 69(10):613-616.
13.	G?hl J, Hohenberger W, Merkel S.Lymph node dissection in rectal carcinoma:TME and what else?[J].Onkologie, 2009, 32(1-2):57-61.
14.	孔杰,楊忠全,鄔顯琨,等.低位直腸癌保肛手術40例臨床分析[J].河北醫學, 2007, 13(7):834-836.
15.	李昂,曹鋒,方育,等.術前放化療結合全直腸系膜切除在低位進展期直腸癌治療中的應用[J].中國普外基礎與臨床雜志, 2012, 19(9):971-974.
16.	Park YA, Sohn SK, Seong J, et al.Serum CEA as a predictor for the response to preoperative chemoradiation in rectal cancer[J].J Surg Oncol, 2006, 93(2):145-150.
17.	Yoon SM, Kim DY, Kim TH, et al.Clinical parameters predicting pathologic tumor response after preoperative chemoradiotherapy for rectal cancer[J].Int J Radiat Oncol Biol Phys, 2007, 69(4):1167-1172.
18.	陳綱,李世擁,于波,等.直腸癌術前放化療反應的相關因素分析[J].中國普外基礎與臨床雜志, 2014, 21(2):177-181.

1. ?Bosset JF, Collette L, Calais G, et al.Chemotherapy with preoperative radiotherapy in rectal cancer[J].N Engl J Med, 2006, 355(11):1114-1123.
2. Greto D, Paiar F, Saieva C, et al.Neoadjuvant oxaliplatin and 5-fluorouracil with concurrent radiotherapy in patients with locally advanced rectal cancer:a single-institution experience[J].Radiol Med, 2013, 118(4):570-582.
3. Improved survival with preoperative radiotherapy in resectable rectal cancer.Swedish Rectal Cancer Trial[J].N Engl J Med, 1997, 336(14):980-987.
4. Kapiteijn E, Marijnen CA, Nagtegaal ID, et al.Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer[J].N Engl J Med, 2001, 345(9):638-646.
5. Colorectal Cancer Collaborative Group.Adjuvant radiotherapy for rectal cancer:a systematic overview of 8507 patients from 22 randomised trials[J].Lancet, 2001, 358(9290):1291-1304.
6. 李世正,單吉賢,馬振海,等.直腸癌根治術前輔助放射治療隨機研究的meta分析[J].中國實用外科雜志, 2006, 26(8):598-601.
7. Kuriu Y, Kokuba Y, Murayama Y, et al.Neoadjuvant chemoradiotherapy for locally advanced rectal cancer[J].Gan To Kagaku Ryoho, 2012, 39(12):1951-1953.
8. Habr-Gama A, Perez RO, Nadalin W, et al.Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy:long-term results[J].Ann Surg, 2004, 240(4):711-717.
9. Maas M, Nelemans PJ, Valentini V, et al.Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer:a pooled analysis of individual patient data[J].Lancet Oncol, 2010, 11(9):835-844.
10. Nakagawa WT, Rossi BM, de O Ferreira F, et al.Chemoradiation instead of surgery to treat mid and low rectal tumors:is it safe?[J].Ann Surg Oncol, 2002, 9(6):568-573.
11. Kuo LJ, Liu MC, Jian JJ, et al.Is final TNM staging a predictor for survival in locally advanced rectal cancer after preoperative chemoradiation therapy?[J].Ann Surg Oncol, 2007, 14(10):2766-2772.
12. Heald RJ, Husband EM, Ryall RD.The mesorectum in rectal cancer surgery-the clue to pelvic recurrence?[J].Br J Surg, 1982, 69(10):613-616.
13. G?hl J, Hohenberger W, Merkel S.Lymph node dissection in rectal carcinoma:TME and what else?[J].Onkologie, 2009, 32(1-2):57-61.
14. 孔杰,楊忠全,鄔顯琨,等.低位直腸癌保肛手術40例臨床分析[J].河北醫學, 2007, 13(7):834-836.
15. 李昂,曹鋒,方育,等.術前放化療結合全直腸系膜切除在低位進展期直腸癌治療中的應用[J].中國普外基礎與臨床雜志, 2012, 19(9):971-974.
16. Park YA, Sohn SK, Seong J, et al.Serum CEA as a predictor for the response to preoperative chemoradiation in rectal cancer[J].J Surg Oncol, 2006, 93(2):145-150.
17. Yoon SM, Kim DY, Kim TH, et al.Clinical parameters predicting pathologic tumor response after preoperative chemoradiotherapy for rectal cancer[J].Int J Radiat Oncol Biol Phys, 2007, 69(4):1167-1172.
18. 陳綱,李世擁,于波,等.直腸癌術前放化療反應的相關因素分析[J].中國普外基礎與臨床雜志, 2014, 21(2):177-181.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Subsequent Surgical Treatment for Complete Response Cases after Neoadjuvant Chemoradiotherapy of Low Locally Advanced Rectal Cancer

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