Pros and cons of perioperative therapy in the protection of organ function in rectal cancer.
10.3760/cma.j.cn.441530-20201221-00668
- VernacularTitle:直肠癌围手术期治疗在器官功能保护中的价值与挑战
- Author:
Jian CAO
1
;
Zhan Long SHEN
1
;
Ying Jiang YE
1
Author Information
1. Gastrointestinal Surgery, Beijing University People's Hospital, Beijing 100044, China.
- Publication Type:Journal Article
- Keywords:
Organ function protection;
Perioperative chemoradiotherapy;
Rectal neoplasms
- MeSH:
Chemoradiotherapy;
Humans;
Neoadjuvant Therapy;
Neoplasm Recurrence, Local;
Quality of Life;
Rectal Neoplasms/surgery*;
Treatment Outcome;
Watchful Waiting
- From:
Chinese Journal of Gastrointestinal Surgery
2021;24(4):291-296
- CountryChina
- Language:Chinese
-
Abstract:
The goal of rectal cancer treatment should be to better protect organ function and improve patients' quality of life on the basis of ensuring radical resection. The current evidence has proved the superiority of perioperative chemoradiotherapy in reducing local recurrence and improving long-term survival. From the perspective of organ function protection, however, perioperative chemoradiotherapy has both disadvantages and advantages. Despite the great help in improving long-term outcomes, adverse reactions of chemoradiotherapy can aggravate defecation, urination and sexual dysfunction. Also, for patients with significant or complete remission, if the treatment strategy of local resection or close follow-up is selected, organ function can be preserved to the greatest extent. The key to the choice of treatment is to evaluate preoperatively whether pathological complete response is achieved. It should be kept in mind that preserving organ itself is not the same as protecting organ function. For patients who need perioperative chemoradiation, the optimal treatment methods should be chosen based on the patient's condition. Surgeons should fully evaluate organ function before operation, select the appropriate treatment strategy, pay special attention to the protection of important organs and nerves during surgeries, and carry out close postoperative follow-up and organ function rehabilitation as soon as possible, so as to reduce the incidence of dysfunction and the impact on the quality of life.
