新辅助疗法对食道切除术对cT2N0M0食道腺癌的影响
Jorge Humberto Rodriguez-Quintero1, Mohamed K Kamel2, Rajika Jindani1
1Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, NY, USA.
对临床T2N0M0食道腺癌的新辅助化疗 (NT) 不会使手术结果恶化,并且可能改善存活率,特别是在5厘米以上的瘤中. 最少侵入性食道切除术在NT后是可行的.
科学领域:
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
- 临床试验 临床试验
背景情况:
- 在临床阶段T2N0M0食道腺癌中新辅助化学放射治疗 (NT) 的作用仍在争论中.
- 最佳的管理策略需要评估术后和瘤的结果.
研究的目的:
- 评估NT对食道切除术结果的外科影响.
- 评估NT在患有临床IIA期食道腺癌的患者中的瘤益处.
主要方法:
- 利用国家癌症数据库 (2010-2019) 对患有cT2N0M0食道腺癌的患者.
- 使用倾向匹配分析来比较新辅助化疗和放射治疗 (NT) 与前期手术 (S).
- 使用后勤回归,卡普兰-梅尔和考克斯回归分析了术后结果和生存率.
主要成果:
- 在一个倾向匹配的队列中,NT显示了可比的转化率,停留时间长度,再入院率和30/90天死亡率与前期手术.
- 新辅助化学辐射疗法 (NT) 与瘤大于5厘米 (HR 0.30) 的患者的生存率有所改善.
结论:
- 新辅助化学放射治疗 (NT) 不会增加技术复杂性,也不会对食道切除术后的术后结果产生负面影响.
- 最少侵入性食道切除术是NT之后的一个可行的选择.
- 在特定的cT2N0M0食道癌症病例中,NT与改善的生存率有选择性关联.
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