在患有胆道癌症的患者中,辅助化疗的难度
Tatsuaki Sumiyoshi1, Kenichiro Uemura2, Ryuta Shintakuya1
1Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Langenbeck's archives of surgery
|November 24, 2023
概括
胆道癌 (BTC) 患者的辅助化疗常常受到复杂的手术,如胆道切除肝切除术 (BDR) 的阻碍. 这些手术后的胆汁泄漏是接受这一关键癌症治疗的重大障碍.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 胆道癌 (BTC) 在术后治疗中提出了重大挑战.
- 辅助化疗是切除BTC治疗的关键组成部分.
- 了解辅助化疗的障碍对于改善患者的治疗结果至关重要.
研究的目的:
- 调查影响胆道癌 (BTC) 手术后患者辅助化疗的施用因素.
- 为了确定阻碍辅助化疗的特定外科手术程序和并发症.
主要方法:
- 对168名BTC患者的临床数据进行了回顾性分析,这些患者接受了治疗意图手术.
- 为了进行比较分析,分层分为辅助性和非辅助性化疗组.
- 多变量分析以确定与没有辅助化疗管理相关的独立因素.
主要成果:
- 141名患者 (83.9%) 接受了辅助化疗;27名 (16.1%) 没有.
- 肝切除术与肝外胆道切除 (BDR) 与没有辅助化疗的显著更高率相关 (p < 0.001).
- 胆汁泄漏是拒绝化疗的最常见原因,特别是在用BDR进行肝切除术后. 手术前贫血也是一个重要因素.
结论:
- 用BDR进行肝切除术是BTC中辅助化疗的主要手术障碍.
- 在BDR复杂肝切除术后,耐火性胆汁泄漏经常会阻止辅助化疗的使用.
- 手术前贫血是另一个与不使用辅助化疗相关的独立因素.
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