介质镜与内声学用于肺癌的介质结分期:一个随机试验
Jouke T Annema1, Jan P van Meerbeeck, Robert C Rintoul
1Department of Pulmonology, C3-P, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. j.t.annema@lumc.nl
JAMA
|November 25, 2010
概括
将内声学与外科分期结合起来,可以改善非小细胞肺癌 (NSCLC) 中枢节点分期. 这种方法提高了检测转移的灵敏度,并减少了NSCLC患者不必要的胸切除术.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 诊断成像 诊断成像 诊断成像
背景情况:
- 在可切除的非小细胞肺癌 (NSCLC) 中,中结节的分期至关重要.
- 目前的手术分期方法有局限性,导致不必要的胸切除术.
- 指导方针建议进行内声学,然后进行手术,作为另一种分期策略.
研究的目的:
- 为了比较两种推的肺癌分期策略的疗效.
- 评估对中结节转移的敏感性和不必要的胸腔切除率.
主要方法:
- 一个随机控制的多中心试验,涉及241名可切除的NSCLC患者.
- 患者被随机分配到即时的手术分期或内声学,如果需要,随后进行手术分期.
- 主要结局是对N2/N3结节转移的敏感性;次要结局包括不必要的胸切除术和并发症率.
主要成果:
- 结合的内声学和手术分期策略显示,与单独的手术分期相比,检测中枢结节转移的灵敏度 (94%) 较高 (79%).
- 这种综合方法显著减少了不必要的胸切除术 (7%与18%).
- 两组之间并发症的发生率相似.
结论:
- 一种将内声学与手术分期相结合的分期策略为NSCLC中中枢结节转移提供了更高的灵敏度.
- 这种综合方法有效地减少了不必要的胸切除术,改善了患者管理.
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