胸管切除对食道切除术后长期生存的影响:个体患者数据的元分析
Alberto Aiolfi1, Davide Bona2, Matteo Cali2
1I.R.C.C.S Ospedale Galeazzi - Sant'Ambrogio, Division of General Surgery, Department of Biomedical Science for Health, University of Milan, Milan, Italy. alberto.aiolfi86@gmail.com.
Annals of surgical oncology
|July 20, 2024
概括
在食道切除术期间的胸腔切除 (TDR) 并没有改善长期生存结果. 对于接受食道切除术的患者,不建议进行常规的TDR,因为它没有提供生存益处.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 免疫学 免疫学 免疫学
背景情况:
- 建议用胸管切除 (TDR) 进行激进食管切除,以增强淋巴切除和减少复发.
- 由于免疫调节效应,人们对TDR对长期生存的潜在负面影响存在担忧.
研究的目的:
- 评估胸腔切除术 (TDR) 对食道切除术后的长期生存的影响.
主要方法:
- 一个系统的审查和对比TDR与没有TDR在食道切除患者的研究的元分析.
- 在PubMed,MEDLINE,Scopus和Web of Science数据库中搜索到2024年3月15日.
- 使用元分析技术分析了整体生存率 (OS),癌症特异性生存率 (CSS) 和无疾病生存率 (DFS).
主要成果:
- 分析包括6项研究,涉及5756名患者;TDR在49.1%的患者中进行.
- 在4年的随访中,在TDR和noTDR组之间没有观察到OS,CSS或DFS的显著差异.
- TDR与更多的中枢淋巴结被摘取有关,但术后胆胸瘤的风险更高.
结论:
- 胸管切除 (TDR) 似乎没有改善食道切除患者的长期存活率 (OS,CSS,DFS).
- 常规的TDR不建议在食道切除术期间作为标准程序.
- 可能需要进一步的研究来澄清TDR在特定患者子组中的作用.
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