在局部先进的西格结肠癌新辅助化疗后,全国范围的结果-A倾向性得分-匹配分析
Karishma Kodia1, Ahmed Alnajar1, Carlos T Huerta1
1Division of Colon and Rectal Surgery, Department of Surgery, University of Miami Leonard Miller School of Medicine, Miami, FL, USA.
The American surgeon
|November 16, 2023
概括
新辅助化疗 (NAC) 在先进的西格结肠癌中很少使用 (1.5%),但与学术中心和特定的保险类型相关. 尽管下降阶段的好处,但NAC在本研究中没有影响生存率或切除率.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 临床研究 临床研究
背景情况:
- 新辅助化疗 (NAC) 在先进的西格结肠癌中的作用需要描述.
- 潜在的好处包括瘤降级和优化R0切除.
- 研究了NAC在学术环境中的利用和影响因素.
研究的目的:
- 为了确定新辅助化疗在晚期西格状结肠癌中的利用率.
- 为了确定与新辅助化疗的使用相关的因素.
- 评估新辅助化疗对瘤结局的影响.
主要方法:
- 使用国家癌症数据库 (2004-2017) 进行回顾性队列研究.
- 包括临床T3-T4,N0-2,M0西格状结肠癌接受切除的患者.
- 排除接受新辅助辐射或转移性疾病的患者;使用倾向性得分匹配.
主要成果:
- 在23,597名患者中,只有1.5%接受了NAC.
- 在学术和大批量中心,以及私人/政府保险中,NAC的使用率更高.
- NAC组显示了N2到N1降级的改善,但生存率,R0切除率或再录取率没有显著差异.
结论:
- 获得包括NAC在内的多学科护理与学术/大批量中心和特定保险有关.
- 在这个队列中,新辅助化疗没有显示出生存益处.
- 可能需要进一步的研究来确定NAC在晚期西格状结肠癌中的最佳作用.
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