在接受食道切除术以治疗食道癌症的老年患者中,新辅助化疗的指示
Kotaro Yamashita1, Kota Momose2, Koji Tanaka2
1Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. kyamashita@gesurg.med.osaka-u.ac.jp.
Surgery today
|October 31, 2023
概括
在老年食道癌症患者 (75岁以上) 中,新辅助化疗 (NAC) 没有改善表现状态为1或更高的患者的存活率. 对NAC的良好的病理反应与这个老年人群中更好的结果相关.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 手术瘤学手术瘤学
背景情况:
- 在老年患者 (75岁以上) 中,食道癌带来了独特的挑战.
- 新辅助化疗 (NAC) 是一种标准治疗方法,但其在老年患者中的有效性需要研究.
- 通过食道切除术进行手术是常见的,需要对外科手术后期结果进行评估.
研究的目的:
- 确定75岁或以上食道癌症患者新辅助化疗 (NAC) 的指示.
- 为了在这个特定的人群中比较前期手术和NAC之后的手术之间的结果.
- 确定影响治疗中老年食道癌症患者预后的因素.
主要方法:
- 对155名75岁以上的食道癌患者进行了回顾性分析,这些患者接受了食道切除术 (2010-2020).
- 前期手术 (US) 和NAC组之间的患者特征和术后结果的比较.
- 根据性能状态 (PS) 和对NAC的病理反应分层的生存分析.
主要成果:
- 与美国组相比,NAC组的患者更年轻,病情更为发达.
- 在NAC和美国组之间,术后并发症的发生率相似.
- 对NAC的良好的病理反应显著改善了与反应差或单独使用美国相比的预后. 对于PS 0患者,5年后的生存率为56.5% (NAC) 和38.1% (美国). 在PS 1-2患者中,5年生存率为28.1% (NAC) 和57.1% (美国).
结论:
- 新辅助化疗 (NAC) 没有改善老年食道癌患者的术后预后,他们的性能状态 (PS) 为1或更高.
- NAC可能有利于PS 0的老年患者,特别是那些获得良好的病理反应的人.
- 需要进一步的研究,以根据表现状态和对治疗的反应来完善老年食道癌症患者的治疗策略.
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