局部进展期直肠癌新辅助放化疗后病理完全缓解的复发模式

Recurrence pattern of pathological complete response after neoadjuvant chemoradiotherapy in locallyadvancedrectal cancer

中低位局部进展期直肠癌接受新辅助同步放化疗后,部分患者可实现病理完全缓解(pCR),pCR后出现复发的概率较小,其术后治疗及随访策略尚未统一。本文总结pCR患者的复发模式,包括远处转移率、远处转移时间与转移的部位特点、局部复发率及局部复发时间特点等,以期对pCR患者的术后治疗及随访提供参考。pCR患者的总体复发比例低,局部复发少见,以远处转移为主,最多见的转移部位是肺脏,其次是区域外的淋巴结转移,复发时间推迟,故应该适当调整复查和随访方案,延长随访时间,并对易复发部位重点监测。

Patients with locally advanced rectal cancer who undergo neoadjuvant chemoradiotherapy may achieve pathological complete response(pCR).The incidence of recurrence is low among patients with pCR,there is still a lack of consensus on postoperative treatment and follow-up strategy.This review summarizes the recurrence patterns of patients with pCR,including distant metastasis rate,characteristics of distant metastasis time and location,local recurrence rate,and local recurrence time.The aim is to provide reference for the postoperative treatment and follow-up strategy of patients with pCR.Patients with pCR have a low recurrence rate,with infrequent local recurrence.Distant metastasis is the most common recurrence pattern,primarily in the lung and secondly in the regional lymph node.The time of recurrence is delayed which suggests the need for appropriate adjustments to follow-up strategy,extending the follow-up period,and placing emphasis on monitoring sites prone to recurrence.