辅助系统疗法改善了上道泌尿道癌的激进脏切除术后的生存率
Francesco Di Bello1,2, Letizia Maria Ippolita Jannello3,4, Carolin Siech3,5
1Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Canada. fran.dibello12@gmail.com.
Annals of surgical oncology
|July 20, 2024
概括
辅助化疗 (AC) 显著降低了癌症特异性死亡率 (CSM) 在上路泌尿道癌 (UTUC) 患者的癌症,淋巴结阳性 (N1-2) 疾病后,激进性瘤切除术 (RNU). 然而,AC不会影响淋巴结阴性 (N0) UTUC患者的CSM.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 癌症研究 癌症研究
背景情况:
- 上道泌尿道癌 (UTUC) 是一种罕见的恶性瘤.
- 激进脏切除术 (RNU) 是UTUC的标准手术治疗方法.
- 辅助化疗 (AC) 有时用于RNU后的高级UTUC.
研究的目的:
- 根据辅助化疗 (AC) 状态,评估用RNU治疗的UTUC患者的生存差异.
- 专门分析pT2-T4和/或N1-2 UTUC患者的癌症特异性死亡率 (CSM).
主要方法:
- 使用了监测,流行病学和最终结果 (SEER) 数据库 (2007-2020).
- 接受AC治疗的患者与仅接受RNU治疗的患者进行了比较.
- 使用卡普兰-梅尔图和多变量考克斯回归模型来评估CSM.
主要成果:
- 在1995年的UTUC患者中,40%接受了AC.
- 随着时间的推移,AC的使用显著增加,特别是在节点阳性 (N1-2) 患者中.
- 在所有T阶段 (T2-T4) 的节点阳性 (N1-2) 患者中,AC独立与较低的CSM相关 (HR 0.64,p<0.001).
- 在节点阴性 (N0) 患者中,AC并没有显著影响CSM.
结论:
- 辅助化疗 (AC) 表明,在经过激进瘤切除术 (RNU) 的淋巴结阳性 (N1-2) 上道泌尿道癌 (UTUC) 患者中,对生存有好处.
- 对癌症特异性死亡率 (CSM) 的AC的好处是特定于节点阳性疾病,不扩展到节点阴性 (N0) UTUC患者.
- 这些发现强调了节点状态在指导使用AC后RNU为UTUC的重要性.
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