预后和转换手术的预测因素对于最初无法切除的晚期结肠直肠癌
Gaku Ohira1, Satoshi Endo2, Shunsuke Imanishi2
1Department of Frontier Surgery, Chiba university graduate school of medicine, 1-8-1 Inohana, Chuuou-ku, Chiba, 260-8670, Japan. Ohira@faculty.chiba-u.jp.
Langenbeck's archives of surgery
|June 11, 2024
概括
晚期结直肠癌的转化手术比单独化疗提供更好的生存率,尽管复发很常见. 左侧原发性瘤和正常的CA19-9水平预测了在无法切除的病例中成功的转换手术.
科学领域:
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
- 先进的结肠直肠癌治疗方法
背景情况:
- 患有远程转移的晚期结直肠癌 (CRC) 通常呈现为不可切除的.
- 转化手术旨在在新辅助疗法后切除最初无法切除的瘤.
- 确定转化手术的候选人对于改善结果至关重要.
研究的目的:
- 为了评估最初无法切除的晚期结直肠癌的转化手术的结果.
- 在这个患者群体中确定成功转换手术的预测因素.
主要方法:
- 远程转移性CRC患者进行前期手术,新辅助化疗,转换手术或单独化疗的回顾性比较 (2007-2020年).
- 进行了单变量和多变量分析,以确定与实现转换手术相关的因素.
主要成果:
- 在最初无法切除的患者中,7.1% (17/239) 进行了转换手术.
- 转换手术组的整体存活率比仅化学疗法更好,但比前期手术更差.
- 在转换手术后,无复发生存时间较短;没有观察到完全治愈.
- 左侧原发性癌症和正常的CA19-9水平是成功转换手术的独立预测因素.
结论:
- 转换手术改善了晚期CRC的整体存活率,相比单独使用化疗,尽管复发率很高,并且没有报告治愈.
- 患有左侧原发性瘤和正常CA19-9水平的患者更有可能成为转化手术的合适候选人.
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