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Terapia neoadjuvante e cirurgia no adenocarcinoma retal: analise dos pacientes com remissao tumoral completa no reto

机译:直肠腺癌的新辅助治疗和手术:直肠癌完全缓解的患者分析

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摘要

INTRODUCTION: the standard treatment for locally advanced extra-peritoneal rectal adenocarcinoma, consists of neoadjuvant treatment with radiotherapy and chemotherapy followed by total mesorectal excision.OBJECTIVE: evaluate, retrospectively, the patients submitted to neoadjuvant therapy and surgery that presents with total remission of the lesion in the anatomopathological examination.METHODS: between 2000 and 2010, 212 patients underwent surgery at the Coloproctology Unit at DMAD at FCM-UNICAMP. They were grouped as: rectosigmoidectomy and colorectal anastomosis (n = 54), rectosigmoidectomy with coloanal anastomosis (n = 41), 114 abdominoperineal resection of the rectum (n = 114) and other (n = 3).RESULTS: thirty (14.2%) patients (mean age 57.6 years; 60% males) showed complete remission of the rectal lesion. 4 (13.3%) had compromised lymph nodes and/or lymphatic invasion At follow-up (mean 51.9 months), 4 (13.3%) presented with local recurrence (one patient) or distant metastases (two patients had liver metastasis, one had liver and lung, and one had bone metastasis). The mean survival was 86.7%.CONCLUSION: patients with a complete tumor response show ed an increased survival rate, however, the same patients without evidence of residual tumors could develop local recurrence or distant metastases on a later follow-up.
机译:引言:局部晚期腹膜外直肠腺癌的标准治疗方法包括新辅助治疗,放疗和化疗,然后进行全直肠系膜切除术。目的:回顾性评估接受新辅助治疗和手术治疗的患者,这些患者的病灶全部缓解。方法:方法:在2000年至2010年间,有212名患者在FCM-UNICAMP的DMAD的肠内科进行了手术。它们分为:直肠乙状结肠切除术和结直肠吻合术(n = 54),直肠乙状结肠切除术伴结肠吻合术(n = 41),直肠直肠癌腹腔切除术114例(n = 114)和其他(n = 3)。结果:30(14.2%) )患者(平均年龄57.6岁;男性占60%)显示直肠病变完全缓解。 4例(13.3%)淋巴结受损和/或淋巴管浸润受损随访(平均51.9个月),4例(13.3%)出现局部复发(1例)或远处转移(2例发生肝转移,1例发生肝转移)和肺部,其中之一发生了骨转移)。平均存活率为86.7%。结论:具有完全肿瘤反应的患者显示出更高的存活率,但是,没有残留肿瘤证据的相同患者在随后的随访中可能发生局部复发或远处转移。

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