Advances in preoperative treatment of colorectal cancer
10.3760/cma.j.cn115610-20220427-00238
- VernacularTitle:结直肠癌术前治疗进展
- Author:
Jianmin XU
1
;
Dexiang ZHU
Author Information
1. 复旦大学附属中山医院结直肠癌中心 上海结直肠肿瘤微创工程技术研究中心 复旦大学附属中山医院肿瘤防治中心,上海 200032
- Keywords:
Colorectal neoplasms;
Neoadjuvant therapy;
Total neoadjuvant treatment;
Immunotherapy;
Conversion therapy
- From:
Chinese Journal of Digestive Surgery
2022;21(6):737-742
- CountryChina
- Language:Chinese
-
Abstract:
Preoperative treatment of colorectal cancer includes neoadjuvant therapy for initial resectable patients and conversion therapy for initial unresectable patients. In locally advanced rectal cancer, on the basis of neoadjuvant chemoradiotherapy or radiotherapy, increasing the intensity of concurrent chemotherapy, or raising postoperative adjuvant chemotherapy before surgery, or combining with immunotherapy can increase pathological downstaging, contribute to organ preservation, and improve survival of patients. In locally advanced colon cancer, neoadjuvant chemotherapy can improve surgical outcomes. In patients with resectable colorectal liver metastases, neoadjuvant chemotherapy is recommended in patients with unfavorable prognostic factors, but it remains controversial whether it should be combined with targeted therapy. However, in patients with initially unresectable colorectal liver metastases, under the guidance of molecular typing, chemotherapy, especially triple-drug chemotherapy, combined with targeted therapy, is expected to achieve higher objective response rate and convertible rate, thus accepting surgical resection, which improves long-term survival. In addition, for the patients with mismatch repair deficient/micro-satellite instability-high metastatic colorectal cancer, programmed death-1 monoclonal antibody (mAb) and/or cytotoxic T lymphocyte-associated antigen-4 mAb have become the standard first-line treatment option.
