Palavras-chave
Tratamento
Quimioterapia
Radioterapia
Cirurgia
Como Citar
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Resumo
Objetivo: Revisar os principais avanços no diagnóstico, estadiamento e tratamento do câncer retal (CR), com ênfase nas estratégias contemporâneas de preservação de órgãos, como terapia neoadjuvante total (TNT) e protocolo watch and wait (WW). Revisão bibliográfica: O CR representa um importante problema de saúde pública devido à elevada incidência, morbimortalidade e impacto funcional. Sua carcinogênese envolve interação complexa entre fatores genéticos, epigenéticos, ambientais e inflamatórios, destacando-se alterações nos genes APC, KRAS e TP53 e a instabilidade de microssatélites. O diagnóstico fundamenta-se na integração entre avaliação clínica, colonoscopia, anatomopatológico e métodos de imagem, com destaque para a ressonância magnética (RM) pélvica de alta resolução no estadiamento locorregional. O tratamento incorporou excisão total do mesorreto (ETM), radioquimioterapia neoadjuvante, TNT e estratégias de preservação de órgãos. Considerações finais: A estratégia WW constitui alternativa para pacientes criteriosamente selecionados com resposta clínica completa (RCC), mediante avaliação multimodal e vigilância rigorosa. A individualização terapêutica e abordagem multidisciplinar são fundamentais para otimizar o controle oncológico e a qualidade de vida.
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