肺移植后的肺癌:早期检测和治疗性手术推动了长期的生存率
Sophie Saing1, Kinan El Husseini2, Clément Picard3
1Pulmonology and Lung Transplant Department, Marie-Lannelongue Hospital, Paris Saclay University, Le Plessis-Robinson, France.
概括
肺移植 (LTx) 后的肺癌很少见,但可以通过手术或放射治疗治疗,特别是在早期阶段. 常规CT查对于早期检测和改善LTx患者的存活率至关重要.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
背景情况:
- 肺癌 (LC) 是肺移植 (LTx) 后的一种罕见但严重的并发症.
- 移植后LC的治疗策略和结果尚未明确.
- 这项研究调查了肺和心脏移植接受者的LC.
研究的目的:
- 分析肺移植 (LTx) 受体中原发性肺癌 (LC) 的特征,治疗和结果.
- 为了比较后LTxLC患者的结果与没有LC的对照接受者.
- 确定影响移植后LC患者生存的因素.
主要方法:
- 在2000年至2023年期间被诊断患有初级LC的LTx和心脏-LTx患者的多中心回顾性观察队列研究.
- 使用卡普兰-梅尔方法分析患者人口统计,癌症阶段,治疗方法和生存率.
- 将LC队列与没有移植后LC的对照接受者进行比较.
主要成果:
- 在7,313名接受者中,有143人 (2%) 在平均5.3年后发展为LC.
- 早期 (I) LC占37%,而转移性疾病占35%.
- 治愈性手术 (避免肺切除术) 在93%的患者中实现了R0切除;在21%的患者中使用了放射治疗. 阶段I,II,III和IV的中位生存时间分别为83,16,10和6个月.
- 在LTx后的LC患者年龄较大,吸烟暴露较高,并且更经常接受单次LTx.
结论:
- 治疗性手术切除 (最好避免肺切除术) 和放射治疗为早期的移植后LC提供了良好的长期存活率.
- 早期和晚期之间显著的生存差异突出了需要进行常规低剂量CT查的必要性.
- 查对单个LTx接受者特别重要,以促进早期LC检测.
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