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在新辅助疗法和手术后,食道状细胞癌没有病理性淋巴结转移的预后因素
Yoichi Hamai1, Manabu Emi1, Yuta Ibuki1
1Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
World journal of surgery
|February 3, 2024
概括
在没有淋巴结转移的食道癌患者中,CEA和NLR水平升高,以及其他因素,预测复发. 手术后治疗可能会使高风险个体受益,即使在新辅助治疗后.
科学领域:
- 在瘤学瘤学.
- 癌症研究 癌症研究
- 临床医学 临床医学
背景情况:
- 病态淋巴结转移 (LNM) 是食道癌预后不佳的关键指标.
- 然而,一些没有LNM的患者在治疗后仍然面临复发的高风险.
研究的目的:
- 在没有病理性LNM的局部晚期食道状细胞癌 (ESCC) 患者中确定无复发生存的预后因素.
- 评估新辅助疗法和其他临床因素对生存的影响.
主要方法:
- 对143名接受新辅助化疗 (NAC) 或化疗放射治疗 (NACRT) 后进行手术的ESCC患者的无复发生存分析.
- 进行了单变量和多变量分析,以确定显著的预后共变量.
主要成果:
- 治疗前的癌胚抗原 (CEA) 水平和中性粒细胞与淋巴细胞比率 (NLR) 是复发的显著独立预测因素.
- 治疗前的LNM,NACRT,差分化的瘤和淋巴血管入侵 (LVI) 也独立预测了复发.
- 随着诊断出不良预后因素的数量,复发率显著增加.
结论:
- 治疗前的CEA和NLR水平,治疗前的LNM,NACRT,差差分化的瘤和LVI与没有病理性LNM的ESCC患者的生存有显著的相关性.
- 考虑对ESCC患者进行术后治疗,这些患者有多重复发指标,即使病理性LNM缺少后新辅助治疗和手术.
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