在食道腺癌中完整的病理反应:它有什么不同?
Britton B Donato1,2, Megan E Campany3, Justin T Brady4
1Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
概括
在食道腺癌的新辅助疗法后实现完整的病理反应显著改善了生存率. 这一发现强调了识别实现完全响应的患者的重要性,以便更好地预测和规划治疗.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 对于食道腺癌的新辅助疗法进展提供了完全病理反应 (pCR) 的潜力.
- 关于食道腺癌患者pCR的发病率和生存影响的数据有限.
- 了解pCR对于完善治疗策略和患者咨询至关重要.
研究的目的:
- 评估食道腺癌患者的完整病理反应 (pCR) 的趋势.
- 在这个患者群体中确定pCR的预测因子.
- 评估pCR在三模治疗和食道切除术后对生存的影响.
主要方法:
- 国家癌症数据库 (NCDB) 对16169名食道腺癌患者的分析.
- 纳入标准:包括食道切除 (2006-2020) 在内的三模治疗.
- 评估与pCR相关的患者因素,分期和生存结果.
主要成果:
- 11.4%的患者实现了PCR;这一比例在2016-2020年增加到17.5%.
- 预测PCR的预测因素包括女性性别,黑人种族,西班牙裔种族和后来的诊断时代.
- 临床II期疾病增加了pCR的概率,而III期降低了它.
- pCR与显著改善的中位生存时间 (86.4个月与30.7个月) 和4年生存时间 (63.3%与39.2%) 相关.
结论:
- 在食道腺癌中,完整的病理反应提供了显著的生存优势.
- 这些发现支持在食道切除术前更好地识别完整的临床反应.
- 对PCR的了解会影响患者的咨询,预后和监测策略.
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