CAJ | 학술논문

直肠癌局部复发是目前直肠癌治疗上的一个难点.尽管目前认为局部复发仍有手术治愈的可能性,但是客观存在可根治率低、手术难度大等情况,其预后并不令人满意.因此对于直肠癌局部复发来说,预防的意义大于治疗.随着直肠全系膜切除原则被广泛接受,直肠癌的局部复发率已得到大幅降低.除此之外,仍有很多因素影响着局部复发的危险度,包括环周切缘、手术方式、肿瘤分期、神经浸润等.合适的放化疗能降低直肠癌局部复发的风险.因此对患者进行危险分层,给予相应治疗,减少局部复发才尤为重要.
직장암국부복발시목전직장암치료상적일개난점.진관목전인위국부복발잉유수술치유적가능성,단시객관존재가근치솔저、수술난도대등정황,기예후병불령인만의.인차대우직장암국부복발래설,예방적의의대우치료.수착직장전계막절제원칙피엄범접수,직장암적국부복발솔이득도대폭강저.제차지외,잉유흔다인소영향착국부복발적위험도,포괄배주절연、수술방식、종류분기、신경침윤등.합괄적방화료능강저직장암국부복발적풍험.인차대환자진행위험분층,급여상응치료,감소국부복발재우위중요.
Local recurrence is a major clinical challenge after primary rectal cancer surgery.Although there is a possibility that R0 resection can be achieved,the outcome is still not favorable due to the low R0 resection rate and complexity of the surgery.Therefore prevention has a higher priority over treatment afterwards.As TME principle is accepted worldwide, the local recurrence rate has been reduced dramatically.And there are other factors associated with local recurrence including CRM, operation type, staging and PNI.Proper chemoradiotherapy may reduce the risk,however benefit always comes with side effect, therefore risk stratification is important.