关键词: 直肠癌, 新辅助放化疗, 临床完全缓解, 病理完全缓解

Abstract:

Controversy and consensus of postoperative complete remission of neoadjuvant chemoradiotherapy for rectal cancer        LI Xin-xiang,LI Da-wei.  Department of Colorectal Surgery, Fudan University Shanghai Cancer Center and Department of Oncology,Shanghai Medical College, Fudan University, Shanghai200032, China
Corresponding author: LI Xin-xiang, E-mail：lxx1149@163.com
Abstract    The goals of treatment for patients with rectal cancer include long-term survival and functional retention. After neoadjuvant treatment of rectal cancer，about 20% of patients reach pCR. How to use the existing detection methods to select true pCR patients，so that cCR and pCR can achieve the maximum degree of compliance，increase the rate of anus preservation or non-surgical treatment，and ultimately reduce radical surgical trauma and functional impairment are the focus of current research. Meanwhile，the choice of follow-up treatment strategies for cCR patients，such as watch and wait，local resection or radical surgery，is currently lacking evidence-based medical evidence support，and it is currently a hot topic of controversy. The author believes that cCR post-treatment after neoadjuvant chemoradiotherapy for rectal cancer should follow the principles of goal-oriented，stratified treatment and full-course management. It is recommended to carry out in the clinical center of a multi-disciplinary treatment team with rich experience in comprehensive treatment of rectal cancer. It’s essential to strictly screen the cases and select the treatment strategy based on the patient's treatment willingness，baseline stage，and lesion characteristics. At the same time，continuous improvement of cCR assessment standards and follow-up strategies，and timely remedial radical surgery can ensure oncology safety，good function and prognosis.

Key words: rectal cancer, neoadjuvant chemoradiotherapy, clinical complete response, pathological complete response