Progression of perioperative treatment for locally advanced colon cancer
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摘要: 局部晚期结肠癌由于不可手术切除、姑息性手术切除、易发生远处转移预后差。新辅助治疗通过缩小肿瘤、降低分期从而增加局部晚期结肠癌手术切除机会,提高R0切除率,但是新辅助治疗模式尚未形成统一。局部晚期结肠癌手术治疗遵循整块切除原则,以R0切除为目的,以全结肠系膜切除为标准术式。辅助化疗在降低术后复发及远处转移的作用已充分论证。本文从新辅助治疗、手术切除、辅助化疗3个方面作一综述,旨在为局部晚期结肠癌围手术期提供有价值的治疗选择和参考,使患者获得最佳的个体化治疗效果和生存获益。Abstract: Locally advanced colon cancer has poor prognosis due to non-resectable cases, palliative resection, and the increased risk of distant metastasis. Neoadjuvant therapy increases resectability of locally advanced colon cancer by reducing tumor loading and degrading stage, and improves the R0 resection rates. But the model of neoadjuvant treatment has not yet been unified. Surgery of locally advanced colon cancer follows the principle of the “en bloc” resection, with the aim of R0 resection and complete mesocolic excision as the standard procedure. The role of adjuvant chemotherapy in decreasing postoperative recurrence and distant metastasis has been fully demonstrated. This review is focused on neoadjuvant therapy, surgery and adjuvant chemotherapy for locally advanced colon cancer,in order to provide valuable guide for the selection of perioperative therapy and reach the best efficiency of individualized therapy and survival benefit for patients.
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