不治愈的T1结肠癌内镜切除的管理
Linn Bernklev1, Jens Aksel Nilsen2, Knut Magne Augestad3
1Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway; Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway.
Best practice & research. Clinical gastroenterology
|March 24, 2024
概括
如果没有发现高风险因素,内镜切除可以治愈早期T1结肠癌. 对于高风险病例,平衡内镜技术与手术至关重要,以避免过度治疗并确保患者的安全.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 结肠直肠癌研究研究
背景情况:
- 内镜切除为T1结肠癌提供治疗潜力.
- 组织学因素,如深层粘膜下侵袭和差差分化预测淋巴结转移的风险.
- 如果缺少转移的高风险因素,完全内镜切除 (R0) 是治愈性的.
研究的目的:
- 审查非治愈的T1结肠癌的管理策略.
- 为了比较先进的内镜切除与手术干预.
- 强调多学科方法和共享决策的重要性.
主要方法:
- 对当前文学进行叙述性回顾.
- 对T1结直肠癌 (CRC) 淋巴结转移的风险因素的分析.
- 对内镜切除与手术切除结果的评估.
主要成果:
- 根据组织学,T1 CRC淋巴结转移的风险从1%到36.4%不等.
- 高风险因素需要进行瘤手术,但许多患者被过度治疗.
- 超过90%的高风险T1CRC患者在手术后缺乏淋巴结参与.
结论:
- 管理T1CRC需要平衡瘤安全与治疗发病率.
- 先进的内镜技术和外科选择呈现出不同的管理途径.
- 多学科的方法对于最佳的T1 CRC患者护理至关重要.
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