在查环境中,影响内镜切除低风险和高风险恶性结直肠多瘤治疗决策的因素
Orietta Giuliani1, Flavia Baldacchini1, Lauro Bucchi1
1Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy.
概括
对恶性结肠直肠多瘤 (MCP) 的结肠直肠癌查指南并不总是遵循. 瘤芽和位置等因素影响了治疗决策,这表明需要更新指南.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床指南 临床指南
背景情况:
- 欧洲指南 (2006) 建议针对高风险恶性结直肠多 (MCP) 进行结肠切除,基于分化,边缘或入侵.
- 高风险的MCP被定义为差差分化,正切除边缘或淋巴血管入侵.
研究的目的:
- 为了确定影响查检测MCP的结肠切除决策的因素.
- 在低风险和高风险患者群体中分析与欧洲指南的偏差.
主要方法:
- 多中心研究954名患者 (年龄50-69岁) 查检测MCP (2005-2016).
- 多级逻辑回归模型用于数据分析.
- 影响外科转诊和遵循指南的研究因素.
主要成果:
- 59.1%的患者接受了结肠切除.
- 与切除相关的因素包括远端/直肠部位,形/平面形态,大小,差异化,阳性边缘,淋巴血管入侵和高度瘤芽.
- 瘤芽强烈影响了低风险MCP的手术,而远端/直肠部有利于高风险MCP的随访.
结论:
- 观察到的治疗选择与当前的欧洲指南有所不同.
- 识别这些影响因素可以帮助改进未来的结直肠癌查和管理指南.
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