在食道状细胞癌中复发的模式和风险因素,这些癌症在新辅助性化疗或放射治疗后达到病理完整反应
Jian Zhong1,2,3,4, Shuogui Fang3,4,5, Rui Chen2,3,4
1Department of Thoracic Surgery, Gaozhou People's Hospital, Maoming, China.
概括
在新辅助化疗或放射治疗 (nCRT) 后,食道状细胞癌与病理完整反应 (pCR) 的复发是常见的,特别是在两年内远程复发. 具有阳性淋巴结病理完整反应 (LN-ypCR反应 (+)) 的患者面临更高的复发风险.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- oesophageal状细胞癌 (ESCC) 的治疗通常涉及新辅助化学放射治疗 (nCRT).
- 在nCRT后的病理完整反应 (pCR) 是一个积极的预后指标,但复发仍然可能发生.
- 了解pCR患者的复发模式和风险因素对于改善结果至关重要.
研究的目的:
- 研究ESCC患者在nCRT后获得pCR的复发模式.
- 在这个患者队列中确定与无复发生存 (RFS) 相关的风险因素.
主要方法:
- 追溯分析96名ESCC患者在nCRT (2008-2018) 后出现pCR.
- 使用Cox比例危险和Fine-Gray竞争风险模型分析RFS的预后因素.
- 定义LN-ypCR反应 (+) 作为没有残留瘤的淋巴结,但显示治疗反应.
主要成果:
- 15.6%的患者出现了复发,复发的中位时间为9.9个月.
- 远程复发是占主导地位的模式 (14.6%),经常涉及LN和肺部.
- LN-ypCR反应 (+) 是更糟糕RFS的独立预测因素 (P < 0.002).
结论:
- 复发是ESCC患者在nCRT后pCR的重大问题.
- 远程复发,主要是在手术后两年内,是主要的模式.
- 患有pCR和LN-ypCR反应 (+) 的患者表现出术后复发的风险较高.
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