在新辅助化疗或放射治疗后对ypT1直肠癌的治疗策略:一项回顾性队列研究
Yibo Cai1, Lai Jiang1, Haixing Ju1
1Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, 1 Banshan E. Road, Hangzhou, Zhejiang, 310022, China.
International journal of colorectal disease
|November 26, 2024
概括
局部切除为ypT1直肠癌提供了类似于激进手术的结果,后的neoadjuvant化疗和放射治疗. 辅助化疗通常不会改善存活率,除了50岁以下的患者.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 在新辅助化学辐射疗法 (nCRT) 后对ypT1直肠癌的最佳治疗方法进行了辩论.
- 即使在nCRT后,区域节点转移的风险也存在.
研究的目的:
- 为了比较局部切除 (LE) 与在nCRT后对ypT1直肠癌进行激进手术的非劣势.
- 为了评估辅助化疗 (ACT) 在这个患者群体的生存益处.
主要方法:
- 对来自SEER的1212名患者和来自ZJCH的91名患者进行了回顾性分析,这些患者接受了nCRT和彻底手术.
- 包括62名从SEER注册表中接受LE的患者.
- 倾向性得分匹配 (PSM) 以平衡治疗组之间的基线特征.
主要成果:
- 在PSM后的LE和激进手术之间,癌症特异性生存率 (CSS) 或整体生存率 (OS) 没有显著差异.
- 区域节点转移 (20.7%在SEER) 与较差的CSS和OS有关.
- 在PSM之后,ACT没有显示生存益处,除了50岁以下的患者.
结论:
- 在瘤学上,局部切除似乎与在nCRT后的ypT1直肠癌的激进手术相当.
- 辅助化疗一般不推,但可能有利于50岁以下的患者.
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