定义非转移性皮上腺癌的最佳管理
Jesse E Passman1, Wajid Amjad2, Jacqueline M Soegaard Ballester2
1Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA. Jesse.Passman@pennmedicine.upenn.edu.
Annals of surgical oncology
|November 5, 2023
概括
手术边缘和瘤生物学显著影响上腺皮质癌 (ACC) 的存活率. 对于晚期疾病,开放式手术改善了生存率,而切除和淋巴切除的程度并没有影响结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 上腺腺癌研究
背景情况:
- 皮上腺癌 (ACC) 是一种罕见且具有攻击性的内分泌恶性瘤.
- 手术切除是主要的治疗方法,但最佳的手术策略和辅助疗法仍在争论中.
- 关于手术技术和辅助治疗对非转移性ACC生存的影响的证据是相互矛盾的.
研究的目的:
- 评估手术技术和辅助疗法对非转移性上腺皮质癌患者的整体生存期的影响.
- 为了确定影响ACC患者接受手术生存结果的关键因素.
主要方法:
- 使用国家癌症数据库 (2010-2019) 进行回顾性队列研究.
- 包括1175名为非转移性ACC手术的患者.
- 使用Cox比例危险模型对整体存活率进行分析,以评估治疗和临床特征.
主要成果:
- laparoscopic 方法,晚期,和积极的手术边缘与更糟糕的生存率有关.
- 切除和淋巴切除术的程度与整体存活率没有显著关联.
- 化学辐射仅在阳性边缘的患者中改善了生存率;腹腔镜切除在第三阶段疾病中恶化了生存率.
结论:
- 瘤生物学和外科边缘状态是非转移性ACC生存的关键决定因素.
- 手术程度和淋巴切除术不会影响整体存活率.
- 开放式手术方法与晚期ACC的改善生存率有关.
相关概念视频
Adrenal Gland Disorders
1.6K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.6K
Chronic Pancreatitis II: Collaborative Care
95
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
95
Cancer Survival Analysis
357
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
357
Combination Therapies and Personalized Medicine
4.9K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
4.9K
Targeted Cancer Therapies
7.7K
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
There are several types of targeted therapies against...
7.7K
Angina IV: Management
9
IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
9


