与食道癌局部和远程复发相关的变量
Sarah Fonseca1,2, Igor Gabriel Silva Ramos1,2, Felipe Antonio Boff Maegawa3
1Universidade de São Paulo, Department of Gastroenterology - São Paulo (SP), Brazil.
概括
瘤的阶段,位置和组织学预测了手术后食道癌的复发. 状细胞癌增加了局部区域的复发,但降低了远程转移的风险,而多式疗法有利于III期患者.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 癌症研究 癌症研究
背景情况:
- 食道癌是侵略性的,在手术后的复发率和死亡率很高.
- 识别复发预测因子对于个性化食道癌治疗至关重要.
- 目前的辅助疗法对食道切除术后复发的影响有限.
研究的目的:
- 确定与食道癌患者复发相关的治疗前和治疗相关因素.
- 分析经食道切除术后的无病生存和复发模式.
- 评估瘤特征和多式疗法对食道癌症结果的影响.
主要方法:
- 对2,057名经过食道切除术的I-III期食道癌患者 (2000-2025) 的回顾性分析.
- 利用圣保罗瘤中心基金会 (FOSP) 数据库获取临床,组织学和治疗数据.
- 采用Cox比例危险和细灰模型来评估生存和复发.
主要成果:
- 先进的瘤阶段,中/上食道位置和罕见的组织学亚型预测了更糟糕的无病生存率.
- 多式疗法在III期瘤中改善了无病生存率.
- 状细胞癌与更高的局部区域复发,但较低的远程转移有关;高瘤等级增加了远程复发风险.
结论:
- 瘤的阶段,位置和组织学是食道癌术后复发的关键预测因素.
- 组织学显著影响复发模式:状细胞癌与腺癌.
- 多式疗法对第三阶段食道癌具有保护作用.
相关概念视频
Barrett Esophagus-I: Introduction
207
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
207
Esophageal Varices-II: Clinical Features and Management
140
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
140
Esophageal Strictures-I: Introduction
269
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
269
Barrett Esophagus-II: Clinical Manifestations and Management
301
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
301
Esophageal Varices-I: Introduction
338
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
338


