宫食道癌的手术结果:一个回顾性队列研究
Chang Yuan1, Zhichao Liu1, Bin Li1
1Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
World journal of surgery
|August 5, 2025
概括
喉保护性食道切除术 (LP) 与全喉-喉-食道切除术 (TPLE) 相比,为宫食道癌 (CEC) 患者提供了更好的生存率和安全性. LP显示CEC的手术结果很有前途,超过了历史的最终化疗和放射治疗数据.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 消化道癌研究 消化道癌研究
背景情况:
- 绝对化疗放射治疗 (dCRT) 是宫食道癌 (CEC) 的标准.
- 由于手术结果数据相互矛盾,需要进一步调查CEC的手术治疗.
研究的目的:
- 为了比较喉保护食道切除术 (LP) 和CEC的全喉-喉-食道切除术 (TPLE) 之间的手术结果.
- 评估手术方法对CEC患者的生存和术后安全性的影响.
主要方法:
- 对152名接受手术的CEC患者的回顾性评估 (2014年5月至2024年5月).
- 通过外科手术进行分层:LP与TPLE.
- 基线数据的分析,外科手术期间的结果,卡普兰-梅尔生存率和多变量考克斯回归.
主要成果:
- LP (85名患者) 的2年整体存活率 (71.2%) 比TPLE (67名患者) (43.5%,p=0.035) 高.
- 在TPLE中,R0切除率较高 (89.6%与75.3%,p=0.024),但非癌症相关死亡率显著更高 (16.4%与4.7%,p<0.001) 和90天死亡率 (7.5%与0%,p=0.010).
- TPLE被确定为OS的一个独立风险因素 (HR 1.872,p=0.021).
结论:
- 与历史的dCRT数据相比,CEC,特别是LP的手术治疗显示出有希望的生存结果.
- 尽管R0切除率较低,但LP提供了优越的生存率和比CEC的TPLE更好的外科安全性.
- 对于精选的CEC患者来说,LP是一种潜在的更安全,更有效的手术选择.
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