在切除的胰腺癌中,病理性瘤对新辅助疗法的反应:它是否会影响预后?
G Donisi1,2, G Nappo3,4, M Pacilli2
1Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.
Updates in surgery
|August 14, 2023
概括
经胰腺癌手术后的新辅助疗法显示出各种病理反应 (PR). 良好的PR (0/1) 显著改善无病生存率和整体生存率,但其预后作用需要进一步研究.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 经过手术切除后的新辅助疗法 (NAT) 越来越多地成为胰腺癌 (PC) 的标准.
- 病理反应 (PR) 评分 (0-3) 评估了NAT后的治疗有效性.
- 评估PR的预后价值对于治疗规划至关重要.
研究的目的:
- 在接受新辅助疗法 (NAT) 和手术切除的胰腺癌 (PC) 患者中评估病理反应 (PR).
- 调查不同级别的PR对患者结果的预后影响.
主要方法:
- 对112名接受NAT和切除治疗的PC患者的回顾性分析 (2011-2020年).
- 病理反应 (PR) 通过美国病理学家学院的系统分级0-3 .
- 统计分析包括PR,DFS和OS的单变量和多变量评估.
主要成果:
- 在15%,61%和24%的患者中,分别观察到PR等级0/1,2和3.
- 在单变量分析中,有利的PR (0/1) 与改善的无病存活率 (DFS) 和整体存活率 (OS) 显著相关.
- 多变量分析确定了诸如胰腺双管切除术,LNR和淋巴血管入侵等因素作为DFS和OS的独立预测因素,而PR没有达到统计学意义.
结论:
- 在胰腺癌 (PC) 中,在新辅助疗法 (NAT) 后,在有限比例的患者中获得了有利的病理反应 (PR).
- 虽然有利的PR显示了改善生存的有希望的趋势,但其独立的预后意义需要进一步验证.
- 多中心研究是必要的,以澄清PR在PC管理中的最终预后作用.
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