盆腔挖掘后的早期失败:谁是坏演员?
Ben Creavin1, Michael Eamon Kelly2, Jawed Noori3
1Trinity St James Cancer Institute Dublin, Ireland, School of Medicine, Trinty College Dublin, Ireland.
概括
对于直肠癌的盆腔切除术后的早期复发与不良的瘤特征和较差的生存率有关. 识别这些"坏人"可以改善晚期直肠癌的患者咨询和治疗策略.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
背景情况:
- 对于局部晚期或复发性直肠癌的盆腔排骨是一种复杂的程序,患者的病率很高.
- 这种手术后的早期复发 (在一年内) 严重影响了生存率和生活质量.
- 识别与早期失败相关的因素对于改善晚期直肠癌管理结果至关重要.
研究的目的:
- 为了确定关键因素 ("坏的行为者") 相关的早期复发后盆腔除局部晚期 (LARC) 和复发性直肠癌 (LRRC).
- 为了比较患有早期复发的患者和晚期复发的患者的特征.
主要方法:
- 在四级转诊中心对接受LARC和LRRC的骨盆挖掘的患者进行了回顾性分析.
- 在早期复发和非早期复发组之间识别和比较患者和瘤特征.
主要成果:
- 在LARC中,早期复发与积极的外科边缘 (R1),遗传突变,外壁静脉入侵和淋巴血管入侵有关.
- 不良的组织病理特征,如差差分化和粘膜性疾病,也与LARC的早期失败有关.
- 在LARC和LRRC队列中,早期复发与与非早期复发组相比,较差的整体存活率显著相关.
结论:
- 瘤特征在预测晚期直肠癌的盆腔除后早期失败方面发挥着至关重要的作用.
- 根据特定瘤特征量身定制治疗策略对于优化患者的治疗结果至关重要.
- 需要采集多中心数据以验证这些发现,并加强患者对预后的咨询.
相关概念视频
01:22Esophageal Perforation-I: Introduction
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Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
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01:28Esophageal Perforation-II: Clinical Manifestations and Management
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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
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