化学辐射后的延迟食道切除术与增加的死亡率或复发无关
Daniel P Dolan1, Geriam Ruiz-Barreto2, Miles McAllister3
1Brigham and Women's Hospital, Boston, Massachusetts, USA.
化学辐射后延迟食道切除术 (CROSS) 并没有恶化食道癌存活率或复发. 然而,更长的等待时间增加了并发症和术后并发症.
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:
- 食道癌症的治疗通常涉及新辅助化学辐射 (CROSS),随后是食道切除术.
- 在CROSS之后,食道切除术的最佳时间受到争论.
- 手术延迟可能会增加患者的并发症,并使康复复复杂化.
研究的目的:
- 为了评估延迟食道切除术对食道癌患者治疗CROSS.治疗的整体生存时间的影响.
- 为了比较经过食道切除术的患者在60天内与CROSS后60天后的结果.
主要方法:
- 对197名经过CROSS和食道切除术的食道癌患者的前性数据库进行了回顾性分析.
- 标准组 (≤60天) 与延迟组 (>60天) 之间的术前特征,术后不良事件,复发和生存率的比较.
主要成果:
- 在标准和延迟手术组之间没有观察到总体存活率或复发率的显著差异.
- 延迟食道切除术患者年龄较大,并发病率较高,并有更多的先前存在的疾病.
- 延迟组经历了手术后主要不良事件的增加 (OR 2.26).
结论:
- 消化管切除术延迟超过CROSS后60天并没有与更糟糕的瘤结果 (复发或存活) 相联系.
- 尽管并发症和术后并发症增加,但推迟手术并没有对生存率产生负面影响.
- 这些发现支持CROSS治疗后手术时间的灵活性.
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