上腺切除术对转移性上皮层癌的整体存活率的影响
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Anis Assad1, Reha-Baris Incesu1,2, Simone Morra1,3
1Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec H2X 0A9, Canada.
The Journal of clinical endocrinology and metabolism
|August 20, 2024
概括
上腺切除术可以改善转移性上腺皮癌 (mACC) 患者的生存率. 这种益处在接受全身疗法或仅肺转移的患者中最为明显.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 内分泌学 在内分泌学.
背景情况:
- 彻底切除上腺皮癌 (ACC) 的唯一已知的治疗方法是手术切除.
- 上腺切除术对转移性ACC (mACC) 的生存影响尚不清楚.
研究的目的:
- 评估上腺切除术对mACC.患者生存结果的现实影响.
- 在转移性疾病的背景下评估初级瘤切除的疗效.
主要方法:
- 利用监测,流行病学和最终结果 (SEER) 数据库 (2004-2020年) 来识别患有mACC的患者.
- 采用卡普兰-梅尔图,多变量考克斯回归和里程碑分析,以根据上腺切除状态来比较结果.
- 进行了敏感性分析,考虑了全身治疗,时间周期和转移部位特征.
主要成果:
- 在543名mACC患者中的36%进行了上腺切除术.
- 多变量分析显示,上腺切除术与总体死亡率显著降低有关 (HR:0.39,P <.001).
- 在接受全身疗法和只有肺转移的患者中观察到生存益处,但在只有肝脏或多重转移的患者中没有.
结论:
- 上腺切除术在mACC患者中显示出潜在的生存益处.
- 这种保护作用在接受全身治疗的患者和患有单一肺转移的患者中尤为明显.
- 进一步的研究可能会完善mACC中上腺切除术的患者选择.
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