库希病成功手术后持久缓解的预测因素:来自多中心RAPID注册表的结果
Matthew C Findlay1,2, Sam Tenhoeve1,2, Jeremiah Alt3
1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City , Utah , USA.
Neurosurgery
|September 18, 2024
概括
手术后库辛病 (CD) 的复发是由较大的瘤大小和较大的年龄预测的. 年轻患者和小瘤患者 (Knosp等级0) 的CD复发风险较低.
科学领域:
- 内分泌学 在内分泌学.
- 神经外科 神经外科
- 在瘤学瘤学.
背景情况:
- 库希病 (CD) 显著影响死亡率和生活质量,长期缓解率有限.
- 鉴定跨形手术后CD复发的预测因子对于患者管理至关重要.
- 之前关于复发预测因子的研究受限于单一中心数据和不一致的发现.
研究的目的:
- 评估多中心的下垂体腺瘤和相关疾病 (RAPID) 数据库的注册.
- 为了确定强大的,非荷尔蒙预测器的CD复发后跨形手术.
- 为了改善患者咨询和预后库辛病.
主要方法:
- 从2011年到2023年对383名接受治疗的CD患者的多中心队列的分析.
- 评估患有和没有复发的患者的术后和长期特征.
- 利用单变量和多变量分析,包括危险预测模型.
主要成果:
- 在383名患者中,达到初始缓解的患者中,有24.8%的患者出现复发 (中位时间为9.99年).
- 复发与更长的住院时间,更大的瘤体积和以前失败的治疗有关.
- 年轻的年龄 (OR=0.95) 和较低的Knosp等级 (等级0:OR=0.09;等级0-2:OR=0.27) 能够防止复发.
结论:
- 瘤大小/入侵和患者年龄是库辛病复发的最强预测因素.
- 较低的Knosp等级 (表明瘤入侵较少) 与复发风险降低有关.
- 对小瘤的长期随访和早期干预可以改善CD患者的治疗结果.
更多相关视频
04:04Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
10.4K
07:43Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
18.8K
相关概念视频
01:29Appendicitis-II: Diagnostic Studies and Management
67
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
67
01:21Cancer Survival Analysis
331
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
331
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
98
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
98
01:29Chronic Pancreatitis II: Collaborative Care
70
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
70