足够的区域淋巴结检查,以分期附录的腺癌
Felipe Lopez-Ramirez1, Armando Sardi2, Mary Caitlin King1
1Department of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA.
Annals of surgical oncology
|December 28, 2023
概括
检查至少十个淋巴结 (LNs) 对于准确的尾癌分期和改善生存率至关重要. 没有检查十个LN会增加错误分类的风险,并对患者的治疗结果产生负面影响.
科学领域:
- 在瘤学瘤学.
- 手术病理学手术病理学
- 癌症的分期 癌症的分期
背景情况:
- 淋巴结 (LN) 转移是尾癌 (AC) 的关键预后因素.
- 目前在AC中进行最低LN检查的指导方针是基于结直肠癌数据,缺乏AC特定的证据.
- 精确的分期对于确定最佳治疗策略和预测患者结果至关重要.
研究的目的:
- 确定所需的淋巴结 (LNs) 的最低数量,以便在尾癌 (AC) 中进行适当的分期.
- 评估LNs数量对AC患者瘤结局的影响.
- 为淋巴结检查建立AC特定的标准.
主要方法:
- 来自国家癌症数据库 (NCDB) (2004-2019) 的II-III期AC患者的回顾性分析.
- 多变量逻辑回归用于评估检查的LN数量与淋巴结阳性疾病 (LNP) 的几率之间的关联.
- 多变量考克斯回归用于评估LN状态和检查充分性对整体生存时间的影响,并根据预后因素进行调整.
主要成果:
- 总共分析了3,602名AC患者;28.5%患有LNP疾病.
- 与检查≥20个LNs相比,检查至少10个LNs被确定为避免减少检测LNP疾病的几率的门.
- 在12.9%的患者中发现了不充分的检查 (<10 LNs),是整体存活期的独立负预后因素 (aHR1.39,p <0.01).
结论:
- 在尾腺癌中,必须检查至少十个淋巴结,以准确确定淋巴结状况,并最大限度地降低低阶段的风险.
- 适当的淋巴结评估与尾癌患者的整体生存率的改善有关.
- 建立特定于尾癌的最小淋巴结数量对于精确的分期和患者管理至关重要.
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