Överlevnaden vid lokalt avancerad rektalcancer kan bli bättre. Centraliserad utredning och behandling ger optimal handläggning
Engelsk titel: Survival in locally advanced rectal cancer can be improved. Optimal management with centralized investigation and treatment
Läs online
Författare:
Palmer, Gabriella
;
Holm, Torbjörn
Email: gabriella.jansson-palmer@karolinska.se
Språk: Swe
Antal referenser: 15
Dokumenttyp:
Översikt
UI-nummer: 10091680
Sammanfattning
Outcome in rectal cancer has improved substantially in recent years, mainly due to preoperative radiotherapy and improved surgical techniques. In 10-15 % of the patients the tumour is locally advanced, involving other organs or structures, and these patients remain difficult to treat. Preoperative assessment includes proctoscopy with biopsies, pelvic MRI, chest/abdominal CT and colonoscopy, followed by multidisciplinary team conference recommending appropriate neoadjuvant treatment. The surgical procedure is extensive with resection of involved structures, often including uro-genital organs and the pelvic floor, and advanced reconstructions requiring different surgical specialists. Complete removal of tumour is a prerequisite for cure. 5-year survival after a radical resection is 40-60 %. Complications, including pain, sexual dysfunction and urinary problems are frequent and this may impair health related quality of life. Due to the complicated multidisciplinary management, and to improve outcome, patients with locally advanced rectal cancer should be referred to specialised centres.