a few days ago, organized by Peking University cancer hospital of Beijing university cancer hospital sunshine Great Wall conference and colorectal tumor BBS opening, experts from the major national cancer center, is a cutting-edge technology in the treatment of rectal cancer has carried on the deep discussion, including colorectal cancer survival data, preoperative chemoradiotherapy, non-surgical treatment, retain the content such as functions, limits to protect anal surgery caused the participants’ great attention.
the presidium of general assembly jia-fu dean, professor wu aiwen highly summarizes the status of rectal cancer treatment: & other; At present the treatment of colorectal cancer, already beyond cure the disease and prolong the survival of the goal. How to improve the patient’s quality of life, keep the anus retained rectal organs, even dignity and improve patients quality of life, will be the focus and direction of the future research. Throughout the &;
rectal cancer after comprehensive treatment curative effect how? Has spread to the recurrence of whether there is any hope?
conference center of gastrointestinal tumor hospital of Beijing university professor wu aiwen, wang Lin, associate professor, associate professor, professor, yong-heng li CAI yong and, according to a study of the tumor hospital of Beijing university from 2007 to 2015, application & other; Preoperative intensity-modulated radiation and chemotherapy plus surgery & throughout; Mode of treatment of 680 patients, after long-term follow-up of 5 years of colorectal cancer related survival rate is as high as 84%, operation regional recurrence rate is only 5%. More the good news is that even if the patient appears the recurrence, transfer, through the director and professor Shen Lin jia-fu MDT is proposed in the multidisciplinary treatment mode, there are still a quarter of the patients can be completely cured recurrence and metastasis, to achieve long-term survival.
in the subsequent meeting, tumor, Chen Ke XingBaoCai professor of Peking University, professor YanKun, professor Wang Weihu, LiuChen, a professor at the medical college hospital professor is zhaolin, people’s hospital professor cumt-ger, Chinese acad med sci tumor hospital Tang Yuan professors and other experts, respectively is also potentially curative colorectal cancer liver metastasis and recurrence of refinement treatment, respectively, the project report, many successful cases show, let us recognize that even in colorectal cancer transfer, through multidisciplinary collaboration, could help patients completely conquer disease, to obtain long-term survival.
& other; Colorectal cancer radiation and chemotherapy after completely disappear, without resection of rectal & throughout; The second kind of rhetoric in the world!
famous director woody Allen once said: & other; The nicest thing in the world is not & other; I love you & throughout; Throughout, but your tumor is benign &; . For patients with rectal cancer, they have already confirmed this malignant disease, after the sick days than the pain of psychological pressure, treatment. But a small percentage of patients with rectal cancer, still have a chance to hear the second kind of rhetoric in the world. They in the tumor hospital of Beijing university after neoadjuvant therapy frontier, won a miraculous effect. These patients with colorectal cancer cells in the radiation and chemotherapy after completely disappear, can cure without resection of rectum. In fact, many surgeons to see this kind of cases will sigh & other; Modern medical technology such as magic & throughout; .
field of rectal cancer, most surgeons inherent thinking is still surgery first, quite a proportion of patients need to accept even the anus rectum permanent removal, the function of the inevitable damage and lower quality of life. Tumor hospital of Beijing university professor wu aiwen, wang Lin, an associate professor of earlier research found that about 20% of the patients after radiation and chemotherapy tumor cells disappear entirely, this part of the patients prognosis is good, the cure rate is higher than 90%. On this basis, the Peking University cancer experts to explore the clinical cases of complete response of 35 cases of rectal cancer after chemoradiation implement the curative effect of non-operative treatment, and in April 2017, published in the Chinese journal of gastrointestinal surgery. The paper’s results show that the implementation of the treatment can be more than 85% of the patients from the rectum resection, achieve long-term cure, maximum retention function.
figure 1 and gastrointestinal tumor hospital of Beijing university professor wu aiwen team center experts, 35 cases of rectal cancer were retrospectively analyzed the successful experience of non-operative treatment, and was first reported in China. At present the treatment has made more than 50 patients benefit, compared with the traditional anal surgery to further improve the quality of life, the greatest degree retained the function;
this meeting, professor wu aiwen report the previous data and the ongoing PKUCH – R01 research, the study used a more potent neoadjuvant chemoradiation, trying to further improve the proportion of rectal cancer after chemoradiation complete remission. Preliminary results showed that the treatment is safe and effective, has more than 20 patients benefit. At the same time, professor wu aiwen and union medical college hospital professor Lin Guole also Shared the radiation and chemotherapy in the meeting on the successful experience of rectal cancer after local excision, the individualized treatment can make patients retained rectal defecation function as far as possible, improve the ability to return to society.
figure – 2 cases of complete response after tumor radiation and chemotherapy (clinical tumor completely disappear). Tumor hospital of Beijing university professor wu aiwen team, through imaging, physical examination, endoscopy and hematologic examination, carefully selected patients with curative effect good, non-operative treatment, closely followed up for 3 to 5 years, about 85% of the patients can be exempted from surgery, long-term cure.
the shifting patterns of rectal cancer treatment: why don’t try so hard the operation?
in addition to the treatment of rectal cancer disappear completely, neoadjuvant chemoradiation another important goal is to shrink the tumor and improve the success rate of surgery. Local advanced rectal cancer, especially the direct operation the recurrence rate is very high, so more and more doctors and patients are accepted & other; Do concurrent chemoradiation, shrink the tumor as much as possible, the last surgery & other; Treatments that increasingly attention & other; Throughout the entire neoadjuvant therapy &; Mode.
in the meeting, professor XiaoYi union medical college hospital, Peking University professor wu aiwen tumor, jin jing, a professor at the Chinese acad med sci tumor hospital carried out respectively in each & other; Throughout the entire neoadjuvant therapy &; Study, share the preliminary results. The treatment even though treatment cycle for 4 to 6 months before surgery, but the maximum to avoid the & other; Resection of rectum and besides, there are residual and again chemoradiation & other; Pattern of the shortcomings, which is beneficial to patients with long-term cure the disease. DetailPic
figure – 3 full neoadjuvant therapy can make the most of the colorectal cancer significantly, improve the operation of radical, avoid the risk of postoperative recurrence, transfer; Left for MRI before chemoradiation, prompt the seminal vesicle gland tumor invasion, circumferential cutting edge positive, such as direct operation is bound to relapse metastasis; Right for patients after six months the whole review of magnetic resonance imaging (MRI) after neoadjuvant chemotherapy, prompt tumors significantly subsided, cut edge negative. The patient eventually stage by stage IIIC drop for IB, without postoperative chemotherapy, rehabilitation home rest, after undergoing surgery to avoid impact of chemotherapy patients condition.
limit protect anal rectal cancer, expanding radical new technology and new methods, such as
in the meeting, many surgical experts also come together to limit protect anal rectal cancer is discussed from the aspects of manipulation, such as expansion effect a radical cure very challenging academic problem, also exchange the experience of the implementation of new technology and new method. Beijing friendship hospital hong-wei yao and six zhongshan hospital professor Kang Liang respectively introduces the whole series of rectal cancer after anal membrane resection (TaTME) surgical technique and the common problems in learning curve; West China hospital, wang, a professor at Peking University hospital professor Wang Xin respectively and the lymph node is put back side of multi-visceral resection for project report; Zhongshan cancer hospital professor zhi-zhong pan, fujian tumor hospital Chen Luchuan also Shared their TME surgery after neoadjuvant chemoradiation experience and technical details.
this & other; The sun of the Great Wall colorectal cancer academic BBS & other; Set the content of the rich and recent clinical practice, focus on the colorectal cancer treatment strategies and all aspects of the diagnosis and treatment technology, make the students attending the audience, there are quite a lot. At the same time, we can see in the experts from the report, the implementation of the new technology and methods, it can bring the actual benefit to patients and treatment of hope, this is the ultimate goal of the academic event organizers held.