Recent advances of surgical treatment for rectal cancer / 中国癌症杂志

ABSTRACT

Incidence and mortality of colorectal cancer(CRC) are rising.There were one million and twenty-three thousand new cases and five hundred and twenty-nine thousand deaths in 2002,which were 8.3% and 7.5% more than that in 2000,respectively.Incidence and mortality of CRC take the third and forth place in all cancers.Mortality in China has increased by 70.7% since 1991,by 4.71% per year in average.Therefore,CRC is one of the heat points in cancer research.In this paper,we focused on the progress in treatment for rectal cancer.Sphincter-preserved resection has an increasing proportion in surgical procedures,owing to improvement of technique,TME and the staplers.Above all,the most important reason seems to be the popular opinion that distal margin of 1 to 2 centimeters is safe enough.TME acts as a "gold standard" in rectal cancer resection,due to its magnificent potential in controlling local recurrence which had decreased from 35%-45% to 3%-11%.Microsurgery is a band-new technique.Laparoscopic colon resection is satisfactory with selective cases.Extended resection results in improving 5-year survival of advanced rectal cancer distal to the reflection to 68%.Further improvement of the outcome depends on multiple modality regimens.Neoadjuvant chemoradiotherapyshows an exciting prospect in some trials.But more multicenter clinical trials are needed to solve the remaining problems.