维尔姆斯瘤患者的脏节约手术,外科德尔菲研究共识声明
Matthijs Fitski1, Guus M J Bökkerink1, Andrew M Davidoff2
1Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Pediatric blood & cancer
|March 10, 2025
概括
儿科威尔姆斯瘤 (WT) 的脏节约手术 (NSS) 是可行的单方面病例的特定标准,包括新辅助化疗和瘤大小. 这项研究定义了扩大NSS利用的外科共识.
科学领域:
- 儿科瘤学 儿科瘤学
- 手术瘤学手术瘤学
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 目前的儿科瘤治疗指南在严格的条件下限制单边威尔姆斯瘤 (WT) 的脏节约手术 (NSS).
- 手术可行性在瘤学指南中没有得到充分的解决,这可能会限制NSS的使用.
- 确定手术可行性对于优化NSS在WT管理中至关重要.
研究的目的:
- 建立外科共识陈述,用于评估符合尼节约手术 (NSS) 资格的威尔姆斯瘤 (WT) 患者.
- 制定手术可行性标准,以便在儿科WT病例中潜在地增加NSS的使用.
主要方法:
- 进行了一项德尔菲研究,涉及34名潜在的外科专家.
- 专家们回答了关于手术,瘤学,禁忌,技术和组织的问卷,用于WT中的NSS.
- 后续调查问卷呈现了从初始答案中得出的封闭式陈述.
主要成果:
- 十一名外科医生参与了这项研究,他们填写了三份调查问卷,并提供了72份陈述.
- 在4周的新辅助化疗后,在瘤<200毫升的情况下,对于非综合性单边WT的脏节约手术 (NSS) 被认为是可行的,并且当部分脏切除与>5毫米边缘可能时.
- 尽管这是可行的,但一些COG外科医生并不主张NSS用于非综合征单边WT.
结论:
- 外科专家使用了德尔菲方法来定义威尔姆斯瘤 (WT) 中NSS的共识陈述.
- 这些共识声明旨在定义WT的外科可行性,可能扩大使用瘤学上适当的NSS.
- 这些发现支持将手术可行性纳入未来的WT治疗方案,以提高NSS的利用率.
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