直肠癌放化疗后等待观察策略
25页1、Watch-and-wait approach versus surgical resection after chemoradiotherapy for patients with rectal cancer (the OnCoRe project): a propensity-score matched cohort analysis,Lancet Oncol Published Online December 16, 2015,2004.10 ,Annals of Surgery,Habr-Gama.eg 265 patients with distal rectal were treated by CRT with 5-FU, Leucovorin and 5040 cGy Five-year OS and DFS rates were 88% and 83% in Resection Group ,100% and 92% in Observation Group,Purpose,oncological outcomes between watch and wait and
2、surgical resection the safety of the watch-and-wait,The definition of a cCR,(1) substantial downsizing with no residual tumor or residual fibrosis only (2) no suspicious lymph nodes on MRI (3) no residual tumor at endoscopy or only a small residual erythematous ulcer or scar (4) negative biopsies from the scar, ulcer, or former tumor location (5) no palpable tumor, when initially palpable with digital rectal examination,Methods,one-to-one paired cohorts of watch and wait versus surgical resectio
3、n using propensity-score matching( T stage, age, and performance status) primary endpoint was DFS secondary endpoints was OS and colostomy-free survival,Methods,CCR standard: after CRT 8 weeks or more absence of residual ulceration, stenosis, or mass within the rectum during digital rectal examination and endoscopic examination,Methods,259 patients from a tertiary cancer centre in Manchester, UK between Jan 14, 2011 and April 15, 2013 CCR-wait-and-see policy group(31) NCCR-surgical resection(228
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