消化管切除术可能在第四阶段的食道腺癌中起作用
Marisa Sewell1, Nicolas Toumbacaris2, Kay See Tan2
1Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
The Journal of thoracic and cardiovascular surgery
|November 24, 2024
概括
积极的局部治疗可能有利于某些患有第四阶段食道腺癌的患者. 与IVA阶段相比,IVB阶段的患者,特别是那些患有寡聚转移性疾病的患者,在食道切除术后的生存率有所改善.
科学领域:
- 胃肠道瘤学 胃肠道瘤学
- 手术瘤学手术瘤学
- 消化道癌研究 消化道癌研究
背景情况:
- 在历史上,第四阶段食道腺癌的预后很差.
- 在晚期的侵袭性局部治疗,包括食道切除术的作用仍在争论中.
- 了解转移性食道癌的生存因素对于治疗规划至关重要.
研究的目的:
- 评估IV期食道腺癌患者积极局部治疗的益处.
- 为了确定与这种患者队列中存活相关的临床病理学和人口学因素.
主要方法:
- 对66名患有第四阶段食道腺癌,接受食道切除术 (2010-2023) 的患者进行了回顾性分析.
- 患者按阶段分层 (IVA与IVB,包括寡头转移和扩散疾病).
- 使用卡普兰-梅尔法估计了整体存活率;临床病理学和人口统计数据进行了比较.
主要成果:
- 在IVA阶段的患者 (n=30) 在手术前接受了新辅助疗法和化疗辐射.
- 第IVB阶段的患者 (n=36) 接受了全身疗法;针对切除的寡度转移 (n=26) 患者,散布 (n=10) 患者接受了息化疗.
- 与IVA阶段患者相比,IVB阶段患者的3年整体存活率 (85%vs. 57%) 和调整后的整体存活率显著更高.
结论:
- 积极的局部治疗,包括食管切除术,可以为精心挑选的患有第四阶段食管腺癌的患者提供生存益处.
- 阶段IVB的疾病,特别是寡度转移的表现,似乎与多式疗法和手术切除后的更好的结果有关.
- 需要进一步的研究来完善患者选择标准,以对晚期食道癌的侵袭性局部治疗进行进一步的研究.
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