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探索食道癌的复发模式 治疗后切除:来自印度一个大容量瘤中心的综合研究
Amitabha Mandal1, Rohan Kapoor1, Sandeep Bhoriwal1
1Department of Surgical Oncology, Dr. BRA-IRCH, All India Institute of Medical Sciences, New Delhi, Ansari Nagar, 110029, India.
Journal of gastrointestinal cancer
|November 7, 2025
概括
食道切除术后食道癌的复发很常见,系统性复发最常见. 对新辅助疗法的反应不佳和病理特征预测复发,指导量身定制的监测策略.
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:
- 食道癌是一个重大的瘤挑战,在治疗切除后的复发率很高.
- 了解复发模式对于优化患者管理和生存结果至关重要.
研究的目的:
- 评估食道癌治愈性食道切除术后的局部区域和系统性复发模式.
- 确定复发的临床和病理预测因素,以告知监测和治疗策略.
主要方法:
- 对314名食道癌患者进行了治疗性食道切除术的回顾性分析.
- 包括从2012年1月到2020年1月的临床,病理和治疗数据.
- 统计分析包括单变量和多变量方法来确定预后因素.
主要成果:
- 整体复发率为30.9%,系统性复发 (12.1%) 比局部区域性复发 (8.0%) 更常见.
- 经常复发的部位包括肝脏 (47%),肺部 (34%) 和中节点 (30%).
- 复发的独立预测因素是新辅助疗法反应不佳,围神经侵袭和疾病晚期.
结论:
- 胃肠切除术后的复发是多因素的,受瘤生物学和治疗反应的影响.
- 通过新辅助疗法反应和病理学来识别高风险患者,可以实现个性化的监测和治疗.
- 量身定制的方法可能会改善食道癌患者的治疗结果.
相关概念视频
Esophageal Perforation-I: Introduction
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
Barrett Esophagus-I: Introduction
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 similar...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...
Barrett Esophagus-II: Clinical Manifestations and Management
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 entails...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Esophageal Strictures-II: Clinical Features and Management
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...