管腺がんによる放射線学的に隠された転移性疾患を予測するリスク要因: 定期的な術前磁気共鳴画像を用いた単一機関での経験
Sibi Krishna Thiyagarajan1, Kareem Sadek2, Alfredo Verastegui1
1Department of Surgery, Mayo Clinic, Jacksonville, Florida.
まとめ
放射線学的に隠された転移性疾患 (ROMD) は,患者の4. 1%で臓手術を中止させた. 境界切除可能な/局所的に進行した管腺癌 (PDAC) は,ROMDの主な予測因子であり,高度なイメージングの必要性を強調した.
科学分野:
- 腫瘍学
- 手術腫瘍学
- 胃腸内科
背景:
- 放射線学的に隠された転移性疾患 (ROMD) に起因する臓手術の中止の発生率に関するデータは限られている.
- 管腺がん (PDAC) の手術は複雑で,手術前画像検査は計画に不可欠です.
- ROMDの危険因子を理解することは,不必要な手術を防ぐために重要です.
研究 の 目的:
- 術前MRIを受けたPDAC患者におけるROMDの危険因子を特定する.
- ROMDによる臓外科手術の中止の発生率を評価する.
- ROMDの臨床的および放射線学的要因の予測価値を評価する.
主な方法:
- 2012年から2022年の間に手術を受けたPDAC患者440人の遡及レビュー.
- ROMDのために手術を中止した患者の特定.
- ROMDの予測要因を決定するバイナリロジスティック回帰分析
主要な成果:
- 18人の患者 (4. 1%) は,ROMDのために手術を中止した.
- 一変性分析では,若さ,BMIの低下,体重減少,腫瘍の大きさ,および境界線切除可能な/局所的に進行した (BR/LA) 疾患が危険因子であることが示された.
- 多変量分析により,BR/LA疾患がROMDの唯一の独立した予測因子 (P=0. 002) であると確認された.
- ROMDは,手術前の癌抗原 (CA) 19-9レベルと関連しませんでした.
結論:
- BR/ LA 患者や切除可能な PDAC 患者には,最も一般的に肝臓転移である ROMD のリスクがあります.
- BR/LA疾患,若い年齢,低いBMI,より大きな腫瘍は,より高いROMDリスクを予測する可能性があります.
- 手術前MRIは,ROMDの発生率とPDACの不必要な手術を減らすのに役立ちます.
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