Improving Rectal Cancer Outcomes with the National Accreditation Program for Rectal Cancer
Improving Rectal Cancer Outcomes with the National Accreditation Program for Rectal Cancer
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DOI：
10.1055/s-0040-1713749
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发表时间：
2020-09-01
影响因子：
1.4
通讯作者：
White, Christopher M.
中科院分区：
文献类型：
--
作者：
Wexner, Steven D.;White, Christopher M.
背景在过去的50年里，直肠癌的治疗经历了巨大的变化。它已经从一种相当病态的疾病演变而来，通常需要一个永久性的造口，几乎完全由外科医生管理，到一个涉及众多学科的专家为患者提供最好的护理。随着手术技术的显著改进，化疗和放疗的使用，先进的成像技术和病理评估的标准化，围手术期发病率和永久性结肠造口率显着下降。我们已经看到了标本质量和复发率以及无病生存率的改善。直肠癌，正如欧洲试验所证明的那样，目的对美国外科医师学会癌症委员会直肠癌国家认证计划（American College of Surgeons Commission on Cancer National Accreditation Program for Recal Cancer）的主要文献进行评价。结果随着美国外科医师学会癌症委员会国家认证计划（American College of Surgeons Commission on Cancer National Accreditation Program for Recal Cancer）的启动，美国外科医师学会癌症委员会直肠癌国家认证计划（American College of Surgeons Commission on Cancer National Accreditation Program for Recal Cancer）的主要文献已被公认为是一种由多学科团队管理的最佳疾病随着直肠癌国家认证计划的实施，我们预计会员和认证数量将大幅增加，从而提高中心的绩效，并最终改善患者的治疗效果。迄今为止，唯一的数据，已被分析是从干预前phase.Conclusions的研究结果在美国和在欧洲取得的成功，它仍然是我们的希望和期望，在美国的直肠癌的管理将迅速改善。
Background The treatment of rectal cancer has undergone dramatic changes over the past 50 years. It has evolved from a rather morbid disease usually requiring a permanent stoma, almost exclusively managed by surgeons, to one that involves experts across numerous disciplines to provide the best care for the patient. With significant improvements in surgical techniques, the use of chemotherapy and radiotherapy, advanced imaging, and standardization of pathological assessment, the perioperative morbidity and permanent colostomy rates have significantly decreased. We have seen improvements in the quality of the specimen and rates of recurrence as well as disease-free survival. Rectal cancer, as demonstrated in European trials, has now been recognized as a disease best managed by a multidisciplinary team.Objective The aim of this article is to evaluate the main body of literature leading to the advances made possible by the new American College of Surgeons Commission on Cancer National Accreditation Program for Rectal Cancer.Results Following the launch of the American College of Surgeons Commission on Cancer National Accreditation Program for Rectal Cancer, we expect dramatic increases in membership and accreditation, with associated improvement in center performance and, ultimately, in patient outcomes.Limitations The National Accreditation Program for Rectal Cancer began in 2017. To date, the only data that have been analyzed are from the preintervention phase.Conclusions Based on the results of studies within the United States and on the successes demonstrated in Europe, it remains our hope and expectation that the management of rectal cancer in the United States will rapidly improve.