对低度尾粘膜瘤监测的风险分层
Kush R Lohani1, Hardik Sonani2, EeeLN Buckarma1
1Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, United States.
概括
手术后低度尾粘膜瘤 (LAMNs) 的复发风险很低. 患有特定风险因素的患者,如右下象限参与和瘤大小小小于2厘米,需要长期监测潜在的瘤瘤 (PMP) 复发.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 在瘤学瘤学.
背景情况:
- 低度的尾粘膜性瘤 (LAMNs) 可能会发展为形瘤 (PMP).
- 对于LAMN复发的发生率和风险因素还没有得到很好的定义.
- 对于LAMN患者的最佳监测策略没有达成共识.
研究的目的:
- 为了确定复发率和确定手术切除后LAMN的风险因素.
- 评估LAMN.监控成像的必要性和持续时间.
主要方法:
- 对125名仅限于尾和有限右下象限参与的LAMNs患者的回顾性分析 (1992-2023年).
- 使用卡普兰-梅尔曲线和考克斯比例危险回归评估复发风险因素.
- 随访时间中位数为51.2个月.
主要成果:
- 只有4%的患者出现了复发,所有患者都进展到PMP.
- 5年和10年的累积复发发病率分别为3%和6%.
- 仅限于右下象限和瘤大小<2厘米的LAMNs是复发的显著风险因素 (P < .05). 患有这些因素的患者,10年复发风险为30%,而没有这些因素的患者为1%.
结论:
- 尾切除术后LAMN的整体复发风险很低.
- 尾切除术本身对于大多数LAMNs来说是足够的治疗.
- 建议对高风险患者进行长期监测 (右下象限参与,瘤大小<2厘米);其他患者可以预期观察.
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