优化胆囊癌的结果:在全球多中心研究中确定徒劳的前置手术的预测因素
Matteo Serenari1,2, Davide Berti2, Belen Rivera3
1Hepatobiliary Surgery and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
Annals of surgical oncology
|March 6, 2025
概括
鉴定胆囊癌 (GBC) 无效手术的危险因素可以减少不必要的干预. 一个预测模型有助于改善患者选择和高级GBC病例的结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 癌症预后 癌症预后
背景情况:
- 胆囊癌 (GBC) 的预后不好,特别是在晚期.
- 晚期GBC的手术提供了有限的生存益处,需要评估干预的徒劳性.
研究的目的:
- 为了确定与胆囊癌无效手术 (FS) 相关的风险因素.
- 开发FS的预测模型,以帮助临床决策.
主要方法:
- 对788名接受了前期GBC手术的患者的国际队列的分析.
- 术后FS的定义是术后5个月内复发或术后90天内死亡.
- 开发一个多变量预测模型和FS概率的在线计算器.
主要成果:
- 虚无手术 (FS) 发生在13.6%的患者中,平均存活时间明显较短 (6.8个月与57.4个月).
- 关键的FS风险因素包括晚期瘤阶段 (T3-T4),淋巴结的参与和多胞体切除.
- 偶然的GBC诊断与FS风险降低有关 (OR0.41).
- 预测模型表现出强大的区分能力 (c-统计:0.749).
结论:
- 优化患者选择对于减少GBC中徒劳的手术至关重要.
- 开发的预测模型作为一个有价值的在线工具,以增强手术决策,并通过尽量减少不有益的干预来改善患者的结果.
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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
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