威尔姆斯瘤与静脉腔血管内延伸:一个外科的前景
Daniel B Gehle1,2, Zachary D Morrison1, Huma F Halepota1
1Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Children (Basel, Switzerland)
|August 29, 2024
概括
具有血管内延伸的威尔姆斯瘤需要专门的护理. 新辅助化疗可以帮助回归瘤血栓,改善儿科癌患者的治疗结果.
科学领域:
- 儿科瘤学 儿科瘤学
- 手术瘤学手术瘤学
- 心胸外科手术 心胸外科手术
背景情况:
- 威尔姆斯瘤 (WT) 是最常见的儿科癌.
- 在静脉上方血管内延伸WT是罕见的,并使手术复杂化.
- 诊断通常是通过成像,患者经常无症状.
研究的目的:
- 审查儿科维尔姆斯瘤与血管内延伸的管理和结果.
- 突出新辅助化疗和手术策略的作用.
主要方法:
- 对患有威尔姆斯瘤和血管内延伸的儿科患者的临床数据的综述.
- 分析治疗方案,包括新辅助化疗和外科血栓切除术.
- 基于瘤扩展水平和治疗方法的结果比较.
主要成果:
- 新辅助化疗适用于肝静脉上方的血栓延伸,通常可以使其回归.
- 瘤扩展到后肝腔,可能会从新辅助疗法中受益,以获得更安全的切除.
- 在 vena caval/心内延伸中成功进行血栓切除术,其存活率与非延伸心血管的存活率相似.
- 转移性疾病或不利的组织学与较差的结果相关.
结论:
- 专注于儿科手术和心胸小组的多式疗法至关重要.
- 新辅助化疗在管理血管内延伸方面发挥着关键作用.
- 优化结果取决于对这些复杂的儿科癌的多学科管理.
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