免疫疗法后的救援肺切除是可行的和安全的
Attila Nemeth1, Maureen E Canavan2, Peter L Zhan3
1Department for Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Tübingen, Germany.
JTCVS open
|September 19, 2024
概括
免疫疗法后的救援肺切除是可行且安全的治疗方法,用于患有形进展的非小细胞肺癌患者. 这种方法,通常涉及叶切除术,显示出高完全切除率和低发病率/死亡率.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 免疫治疗是一种免疫疗法.
背景情况:
- 非小细胞肺癌 (NSCLC) 治疗已通过免疫疗法和化疗辐射得到进展,改善了生存率.
- 在NSCLC患者的寡头进展是一个挑战,具有潜在的局部疗法,如手术作为救援治疗.
- 在免疫治疗后评估救援肺切除术对于完善治疗策略至关重要.
研究的目的:
- 评估免疫治疗后在非小细胞肺癌患者中救援肺切除的可行性和安全性.
- 确定手术结果,包括切除率和病理反应.
- 评估与这种救援方法相关的患者发病率和死亡率.
主要方法:
- 针对NSCLC患者的国家癌症数据库 (2013-2020年) 的回顾性分析.
- 在免疫治疗开始5个月后接受救援手术的患者的鉴定.
- 分析手术类型,R0切除率,完整的病理反应,停留时间,再入院和死亡率.
主要成果:
- 164名患者在免疫疗法后接受了救援肺切除;叶片切除术是最常见的 (74%).
- 实现了高的R0切除率 (89%),其中23%显示出完全的病理反应.
- 观察到较低的发病率和死亡率:住院时间中位数为4天,5%为30天再入院,30天死亡率为0.6%.
结论:
- 免疫疗法后的救援肺切除是NSCLC患者的可行和安全的选择.
- 完全切除的高率和低患者发病率/死亡率支持这种方法.
- 建议考虑在多学科护理中进行形进展后免疫治疗的救援手术.
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