从精准解剖性根治手术到精准功能保全:直肠癌治疗理念变迁与未来展望OA

The treatment paradigm for rectal cancer is under-going a fundamental change from radical resection to function-al preservation.While traditional total mesorectal excision re-duces local recurrence rates,it often comes at the cost of com-promised anal and functional quality of life.In the molecular subtype-guided precision therapy,particularly with the appli-cation of neoadjuvant chemoradiotherapy combined with immu-notherapy,the pathological complete response rate has signifi-cantly improved.This offers the possibility for patients to avoid surgery after achieving a complete response.Clinical practice of the watch-and-wait strategy has shown that patients achiev-ing a clinical complete response have comparable long-term survival outcomes to those undergoing radical surgery,while maximally preserving organ function and quality of life.Howev-er,challenges including insufficient accuracy in response as-sessment,ambiguous patient selection criteria,and the need for optimization of long-term follow-up systems still remain.Looking ahead,rectal cancer management must integrate multi-ple objectives including tumor control,organ preservation,and quality of life.This evolution represents not only technological advancement but also a vital embodiment of patient-centered medical humanism.