尾切除手术与右尾切除手术用于全国队列中的尾神经内分泌瘤:呼吁进一步减少尾切除手术
Swathi R Raikot1, Donald Dean Potter1, Courtney N Day2
1Department of Surgery, Division of Pediatric Surgery, Mayo Clinic, Rochester, MN.
Journal of the American College of Surgeons
|May 5, 2025
概括
尾切除术本身就足以治疗尾的儿科神经内分泌瘤 (NET),即使有积极的边缘. 这种方法确保了儿童的优异生存率,挑战了传统的成人指导方针.
科学领域:
- 儿科瘤学 儿科瘤学
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 患有尾神经内分泌瘤 (NET) 的儿童通常根据成人指导方针进行右半球切除术 (RHC).
- 对于儿科病例,单独进行尾切除是建议的,但其安全性与积极边际尚未得到充分确立.
研究的目的:
- 评估瘤特征与全国一队儿科病人尾 NET 的存活率之间的关联.
- 为了确定单独的尾切除术是否是一种安全有效的治疗方法,即使存在诸如正边缘等高风险特征.
主要方法:
- 确定了一个全国性队列,包括1339名年龄在18岁或更年轻的尾NET患者 (2004-2022年).
- 分析了来自国家癌症数据库的患者数据,比较了尾切除和RHC之间的结果.
- 评估了尾切除术患者的五年生存率,这些患者有或没有高风险特征 (大小,边缘,淋巴结状况).
主要成果:
- 尾切除术在86%的患者 (1,156) 中进行,而RHC在14% (183) 中进行.
- 接受RHC的患者患有较大的瘤和更多的淋巴血管侵袭,但边缘状态没有差异.
- 整体5年和10年生存率很好 (99.9%和99.4%),包括那些仅用尾切除术治疗的人 (99.9%和99.2%).
结论:
- 尾切除术被证实是儿科尾NET的最终治疗方法.
- 进一步切除 (RHC) 不会改善生存结果,即使在尾切除标本上有积极的边缘.
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