低度尾瘤的治疗变化和长期结果
Michael G White1, Neal Bhutiani1, Beth A Helmink2
1Department of Colon & Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
低度尾瘤 (LAMNs) 的治疗方法有很大差异,通常涉及不必要的切除术. 不建议进行常规诊断性腹腔镜检查,并且复发很少,这表明需要对LAMNs进行标准化,不那么侵入性的监测.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 在瘤学瘤学.
背景情况:
- 尾瘤在历史上一直受到异质命名的困扰,导致治疗的不确定性.
- 最近的共识确立了低度尾瘤 (LAMN) 这个术语,但治疗变异仍然存在.
研究的目的:
- 调查LAMNs治疗模式的变化.
- 评估在LAMN患者中采集切除术和诊断性腹腔镜的瘤益处.
- 评估LAMN的长期结果,包括无复发生存率.
主要方法:
- 一个前性维护的附录注册表 (2009-2019) 的回顾性审查.
- 分析治疗变异性,包括胆管切除术,在呈现时的疾病传播和结果.
- 评估患有局部和扩散腹疾病的患者.
主要成果:
- 在136名LAMN患者中,88人患有局部性疾病,48人患有扩散性腹病.
- 对26名患者进行了结肠切除术,因为他们认为有瘤需要,但没有发现结节转移.
- 在41名局部疾病患者的诊断性腹腔镜检查中,没有发现隐性腹转移.
- 用CRS/HIPEC治疗的扩散性疾病的5年无复发生存率为94%,局部性疾病为98%.
结论:
- 在LAMN治疗中存在显著的差异,特别是在转诊到大批量中心之前.
- 对于LAMNs,大肠切除术和常规诊断性腹腔镜往往缺乏瘤效益.
- 低强度监测是适当的LAMNs由于罕见的复发和良好的预后,即使在腹腔疾病.
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