Colorectal cancer (CRC) is the second most prevalent cause of cancer-related death and the third most common cancer globally. Early-stage rectal cancer is defined by lesions confined to the bowel wall, without extension beyond the submucosa in T1 or the muscularis propria in T2, with no indication of lymph node involvement or distant metastasis. The gold standard for managing rectal cancer is total mesorectal excision (TME); however, it is linked to considerable morbidities and impaired quality of life. There is a growing interest in local resection and non-operative treatment of early RC for organ preservation. Local resection options include three types of transanal endoscopic surgery (TES): transanal endoscopic microsurgery (TEM), transanal endoscopic operations (TEO), and transanal minimally invasive surgery (TAMIS), while endoscopic resection includes endoscopic mucosal resection (EMR), underwater endoscopic mucosal resection (UEMR), and endoscopic submucosal dissection (ESD). Although the oncological outcome of local resection of early rectal cancer is debated in the current literature, some studies have shown comparable outcomes with radical surgery in selected patients. The use of adjuvant and neoadjuvant chemoradiotherapy in early rectal cancer management is also controversial in the literature, but a number of studies have reported promising outcomes. This review focuses on the available literature regarding diagnosis, staging, and management strategies of early rectal cancer and provides possible recommendations.
结直肠癌是全球癌症相关死亡的第二大主要原因，也是第三大常见癌症。早期直肠癌定义为病灶局限于肠壁内，未超过T1期的黏膜下层或T2期的固有肌层，且无淋巴结受累或远处转移迹象。直肠癌治疗的金标准是全直肠系膜切除术，但该手术与较高的并发症发生率及生活质量下降相关。目前对早期直肠癌进行局部切除和非手术治疗以实现器官保留的关注日益增加。局部切除方式包括三类经肛门内镜手术：经肛门内镜显微手术、经肛门内镜手术和经肛门微创手术；而内镜切除则包括内镜黏膜切除术、水下内镜黏膜切除术和内镜黏膜下剥离术。尽管当前文献中对早期直肠癌局部切除的肿瘤学效果存在争议，但部分研究表明在特定患者中其疗效与根治性手术相当。辅助治疗与新辅助放化疗在早期直肠癌治疗中的应用同样存在学术争议，但多项研究已报道了具有前景的治疗结果。本综述聚焦于早期直肠癌诊断、分期及治疗策略的相关文献，并提供可行性建议。
Early Rectal Cancer: Advances in Diagnosis and Management Strategies
肿瘤(癌症)患者之家