Evidências científicas sobre o manejo do adenocarcinoma retal / Scientific evidence on the management of rectal adenocarcinoma
DOI:
https://doi.org/10.34119/bjhrv5n1-033Keywords:
Adenocarcinoma, Quimioterapia Adjuvante, Terapia Neoadjuvante.Abstract
A ressecção cirúrgica é a base da terapia curativa para o adenocarcinoma retal, a cirurgia por si só fornece uma alta taxa de cura apenas para pacientes em estágio inicial da doença, a adição de quimioterapia e radioterapia antes e depois da cirurgia parece melhorar o prognóstico da doença. A radioterapia emergiu como um componente importante da terapia adjuvante para câncer retal por causa dos padrões distintos de falha após a ressecção. A terapia neoadjuvante em vez de adjuvante, quimiorradioterapia de longa duração ou RT de curta duração sozinha, é uma abordagem preferida para pacientes com transmural ou tumores com nódulo-positivo, principalmente se estiverem baixos no reto e para aqueles com fáscia mesorretal positiva ou ameaçada. As vantagens da abordagem neoadjuvante incluem melhor controle local, uma maior probabilidade de cirurgia para salvar o esfíncter, um menor risco de disfunção intestinal pós-tratamento e um menor risco de estenose anastomótica.
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