文章：

直肠癌现代诊疗策略：内镜、外科与肿瘤学的整合治疗

Modern Approaches to Rectal Cancer: Integrating Endoscopic, Surgical, and Oncological Care

原文发布日期：28 August 2025

DOI: 10.3390/cancers17172820

类型: Article

开放获取: 是

英文摘要：

Rectal cancer remains a significant clinical challenge due to its complex anatomy and the critical need to balance oncological radicality with functional preservation. Multimodal treatment strategies, including neoadjuvant therapy, advanced endoscopic techniques, and precise surgical approaches, have evolved to optimize patient outcomes. Neoadjuvant chemoradiotherapy improves resectability and local control in locally advanced tumors, while endoscopic treatment offers organ-preserving options for carefully selected early-stage cancers. Surgical resection, primarily through total mesorectal excision (TME), remains the cornerstone of curative therapy, with minimally invasive and transanal approaches enhancing precision and recovery. In advanced and recurrent cases, extended procedures such as pelvic exenteration provide potential for cure despite substantial morbidity. This review summarizes current evidence on the indications, techniques, and outcomes of neoadjuvant, endoscopic, and surgical treatments for rectal cancer, emphasizing individualized treatment planning to achieve optimal oncological and functional results.

摘要翻译： 

直肠癌因其解剖结构复杂，且需在肿瘤根治性与功能保留之间取得关键平衡，仍是临床面临的重大挑战。为优化患者预后，多模式治疗策略不断发展，包括新辅助治疗、先进内镜技术和精准手术方法。新辅助放化疗可提高局部晚期肿瘤的可切除性和局部控制率，而内镜治疗为经严格筛选的早期癌症提供了保留器官的治疗选择。以全直肠系膜切除术为核心的手术切除仍是根治性治疗的基石，微创及经肛入路手术则提升了手术精准度并促进术后恢复。对于晚期及复发病例，尽管并发症发生率较高，盆腔廓清术等扩大手术仍为患者提供了潜在治愈机会。本综述总结了当前关于直肠癌新辅助治疗、内镜治疗及手术治疗适应证、技术及疗效的证据，强调通过个体化治疗方案以实现最佳肿瘤学及功能预后。

原文链接：

Modern Approaches to Rectal Cancer: Integrating Endoscopic, Surgical, and Oncological Care