Precise preoperative staging of low rectal cancer assessed by imaging
10.19538/j.cjps.issn1005-2208.2019.07.06
- Author:
Yi WANG
1
Author Information
1. Department of Radiology,Peking University People's Hospital Beijing 100044,China
- Publication Type:Journal Article
- Keywords:
low rectal cancer;
operation;
magnetic resonance imaging;
staging
- From:
Chinese Journal of Practical Surgery
2019;39(07):667-673
- CountryChina
- Language:Chinese
-
Abstract:
The goal of treatment strategy for patients who has low rectal cancer is preserving sphincter and function and keeping decrease of local recurrence and increase overall survival. In the result of narrow space between tumor and surrounding structure,the positive resection margin increases the local recurrence in patient with low rectal cancer. Magnetic resonance imaging(MRI)preoperatively predict circumferential resection margin according to the relationship between tumor and the low rectal cancer surgical resection plane. MRI,which has been validated by previous studies,low rectal plane assessment,reducing pCRM involvement and avoiding overtreatment through selective preoperative therapy and rationalized use of permanent colostomy. However,surgical treatment of low rectal cancer is controversial,and one of the reasons is the lack of definition and standardization of surgery in low rectal cancer. Classification of low rectal cancers and standardization of surgery according to distance between lowest edge of tumor and depth of tumor invasion permit sphincter and function preserving surgery in of patients with low rectal cancer. In patients with rectal cancer who achieve clinical complete response after neoadjuvant chemoradiotherapy,“watch and wait” is a novel management strategy with potential to avoid major surgery. However,how to select proper candidates and how to assess the complete clinical response need further research.
