消化管切除术后长期幸存者的结果是什么? - 来自随机对照试验的证据 (FFCD9901)
William B Robb1, Julie Veziant2, Laetitia Dahan3
1Department of Oesophageal and Gastric Surgery, Beaumont Hospital and the Royal College of Surgeons in Ireland, Ireland.
概括
对于食道癌的食道切除术后的长期存活并不是一种治疗方法. 晚期复发和第二次原发性癌症发生,需要为幸存者提供适应的监测协议.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 对于食道癌幸存者在食道切除术后的长期结果,人们对其了解甚微.
- 对这个患者群体来说,评估5年以后的瘤结果至关重要.
研究的目的:
- 为了评估食管切除术后5年生存的食管癌患者的长期瘤结果.
- 确定预测早期死亡率和晚期复发模式的因素.
主要方法:
- 来自多中心随机对照试验 (FFCD9901) 的数据分析,比较新辅助化学放射治疗 (NCRT) 加手术与单独手术.
- 包括接受食道切除术的患者,并分析了5年幸存者的临床病理变量.
- 多变量逻辑回归以确定5年之前死亡的预测因素以及复发和第二次原发性瘤发展的评估.
主要成果:
- 总体5年生存率为41.2% (70/170名患者).
- 世卫组织表现不佳的状态 (≥1),晚期PT类别,以及术后并发症预测5年内死亡.
- 20名患者在5年后死亡,9名患者死于食道癌的进展,19名患者出现了第二次原发性恶性瘤 (14名头部/部或肺部).
结论:
- 食道切除术后的5年生存率并不能保证食道癌的治愈.
- 患有早期疾病的大量患者经历了超过5年的晚期复发.
- 第二种原发性癌症的发展是一个相当大的威胁,需要调整监测策略.
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