在治疗食道癌的治疗性食道切除术后,多种模式的治疗对寡度转移的治疗
Naomichi Koga1, Masaru Morita2, Taichiro Nagai1
1Department of Gastroenterological Surgery, NHO Kyushu Cancer Center, 3-1-1 Notame, Minami-Ku, Fukuoka, 811- 1395, Japan.
概括
有限转移性疾病 (Oligometastases) 是术后食道癌复发的关键预后因素. 这些孤立转移的手术切除,特别是在肺部或淋巴结中,可以改善长期生存.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 被定义为有限转移性疾病的寡度转移,越来越多地被认为是癌症治疗中的潜在治疗标.
- 在治疗性食道切除术后食道癌复发会带来重大管理挑战.
- 了解寡头转移性复发的特征和最佳治疗对于改善患者的治疗结果至关重要.
研究的目的:
- 鉴定食道癌治愈性食道切除术后的寡度转移性复发模式的特征.
- 为了评估这个患者群体中寡头转移的预后意义.
- 为了确定有效的治疗策略,以治疗小卵性食道癌复发.
主要方法:
- 在治疗性食道切除术后,对138名患有复发性食道癌的患者进行了回顾性分析.
- 寡头转移的定义是指在单个器官或淋巴结站内有三种或更少的转移性病变.
- 检查复发地点,时间,治疗方法和生存数据.
主要成果:
- 在26%的复发病例中 (36名138名患者中) 鉴定出了寡度转移.
- 淋巴结 (21 位患者) 和肺 (14 位患者) 是最常见的寡头转移性复发部位.
- 与多重转移 (P < 0.0001) 患者相比,患有寡头转移的患者的预后明显更好 (P < 0.0001).
- 手术切除寡聚转移酶显著影响了长期存活率 (P = 0.012).
结论:
- 氧化卵巢扩散是食道癌在食道切除术后复发的重要预后因素.
- 孤立的寡头转移的手术切除,特别是肺和宫淋巴结转移,提供了生存益处.
- 手术切除与化疗或放射治疗的结合方法是管理寡基质转移复发的有希望的策略.
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