Current and future cancer staging after neoadjuvant treatment for solid tumors
Current and future cancer staging after neoadjuvant treatment for solid tumors
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DOI：
10.3322/caac.21640
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发表时间：
2020-11-06
影响因子：
254.7
通讯作者：
Gress, Donna M.
中科院分区：
文献类型：
--
作者：
Byrd, David R.;Brierley, James D.;Gress, Donna M.
直到最近，癌症登记处仅收集诊断时的癌症临床分期，任何治疗前，以及手术切除后的病理分期，前提是手术前没有给予治疗，但他们没有收集新辅助治疗（NAT）后的分期数据。由于NAT越来越多地用于治疗各种肿瘤，因此区分无NAT的临床和病理评估与NAT后的评估变得非常重要，以避免对临床和病理发现的意义产生任何误解。同样重要的是，癌症登记处收集NAT后的数据，以评估这种治疗方法在人群基础上的反应和有效性。前缀y用于表示NAT后的阶段。目前，美国外科医生学会癌症委员会的癌症登记处仅部分收集y阶段数据，并且没有以标准化的方式收集或记录关于NAT的临床反应的数据（yc或治疗后临床信息）。除NAT外，放疗和化疗后的非手术治疗在直肠癌中的使用频率越来越高，并可能扩展到其他治疗部位。以乳腺癌、直肠癌和食管癌为例，回顾NAT后的病理和影像学变化，以证明适当的分期。
Until recently, cancer registries have only collected cancer clinical stage at diagnosis, before any therapy, and pathological stage after surgical resection, provided no treatment has been given before the surgery, but they have not collected stage data after neoadjuvant therapy (NAT). Because NAT is increasingly being used to treat a variety of tumors, it has become important to make the distinction between both the clinical and the pathological assessment without NAT and the assessment after NAT to avoid any misunderstanding of the significance of the clinical and pathological findings. It also is important that cancer registries collect data after NAT to assess response and effectiveness of this treatment approach on a population basis. The prefix y is used to denote stage after NAT. Currently, cancer registries of the American College of Surgeons' Commission on Cancer only partially collect y stage data, and data on the clinical response to NAT (yc or posttherapy clinical information) are not collected or recorded in a standardized fashion. In addition to NAT, nonoperative management after radiation and chemotherapy is being used with increasing frequency in rectal cancer and may be expanded to other treatment sites. Using examples from breast, rectal, and esophageal cancers, the pathological and imaging changes seen after NAT are reviewed to demonstrate appropriate staging.