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在切除II阶段小肠腺癌后进行不充分淋巴切除术的患者的治疗和结果

Jackson A Baril^1,2, Karl Y Bilimoria^1,2, Eugene P Ceppa²

¹Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Journal of surgical oncology

|December 9, 2025

概括

辅助化疗 (AC) 改善了II期小肠腺癌 (SBA) 患者的存活率,这些患者有不充分的淋巴切除术和高危特征. 在没有这些额外风险因素的患者中,AC并没有显著影响存活率.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
胃肠道瘤学胃肠道瘤学

背景情况:

第二阶段小肠腺癌 (SBA) 患者有不充分的淋巴切除术可能会接受辅助化疗 (AC).
在这种情况下,额外的高风险特征的预后价值仍然不清楚.
高风险特征包括T4初级,阳性切除边缘,差分化的瘤或淋巴血管入侵.

研究的目的:

为了确定在II期SBA中AC利用率与不充分的淋巴切除术.
为了确定影响AC接收的因素.
评估AC与生存之间的关联,按高风险特征分层.

主要方法:

利用国家癌症数据库 (2004-2021) 对SBA患者的II阶段.
定义为不充分的淋巴结切除术,在十二指甲瘤中<5个淋巴结,在其他部位<8个淋巴结.
分析了基于高风险特征存在的AC接收和生存结果.

主要成果:

在1765名患者中,29.8%接受了AC.
T4初级,低等级和正边缘与AC接收有关.
在具有高风险特征的患者中,AC改善了5年生存率 (49.9%对31.4%),但不是没有 (67.1%对53.2%).

结论:

辅助化疗与II期SBA患者的生存率改善有关,SBA患者的淋巴切除术和任何高风险特征都不够.
对AC的治疗决定应该考虑多个预后变量.
进一步的研究可能会完善风险分层和治疗指南.

关键词:

肠道新生体是什么意思回顾性研究研究回顾性研究辅助性化疗是一种辅助性化疗.淋巴腺切除术是指淋巴腺切除术.小肠/手术小肠/手术

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