阴道癌的争议:重新审视错误范围
Maureen E Byrne1, Mario M Leitao2, Nadeem R Abu-Rustum2
1Memorial Sloan Kettering Cancer Center, Department of Surgery, Division of Gynecologic Oncology, New York, NY, USA.
概括
在早期的癌中,局部复发是常见的,尽管手术. 有证据表明,小于8毫米的边缘可能是安全的,质疑历史指导方针并减少不必要的发病率.
科学领域:
- 妇科瘤学 妇科瘤学
- 手术病理学手术病理学
背景情况:
- 早期的癌治疗通常需要进行彻底的手术,但局部复发率接近40%.
- 历史指南建议8毫米的无瘤边缘,但这缺乏强有力的证据.
- 癌的治疗失败与高死亡率有关.
研究的目的:
- 评估早期癌手术中需要8毫米的无瘤边缘的必要性.
- 澄清边缘状态在预测局部区域复发中的作用.
- 为 vulva 癌症提供最佳的手术和辅助治疗策略提供信息.
主要方法:
- 审查回顾性研究,检查无瘤边缘和癌复发率.
- 对差异化内皮质瘤和边缘状样硬化症影响的新兴证据的分析.
- 评估与再切割和辅助辐射相关的疗效和发病率,以边缘小于8毫米.
主要成果:
- 许多回顾性研究表明,无瘤边缘<8毫米和局部区域复发之间没有关联.
- 在复发过程中分化的内皮质瘤和状硬化病的作用需要进一步调查.
- 再切割或辅助辐射的边缘<8毫米没有显示明显的益处,并增加了病率.
结论:
- 对于癌,8毫米的无瘤边缘指南可能并不普遍必要.
- 治疗决策应侧重于积极的边缘,为这些病例保留进一步的干预措施,以尽量减少患者的发病率.
- 合作研究和集中护理对于进一步了解罕见的癌至关重要.
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