腹膜转移的组织学等级独立地预测了通过治疗性手术治疗腹膜形瘤的结果
Awen Hasan1,2, Bipasha Chakrabarty2, Christopher Kearsey2
1Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
概括
从尾粘膜瘤 (AMN) 来源的Pseudomyxoma Peritonei (PMP) 中腹膜转移的组织病理学级显著影响了经过细胞还原手术加热腹膜内化疗 (CRS+HIPEC) 后的患者预后. 高度粘膜性周周癌 (HGMCP) 是低整体生存率的强有力的预测因素.
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:
- 形膜瘤 (Pseudomyxoma Peritonei,简称PMP) 是一种罕见的恶性瘤,其特征是由尾粘膜性瘤 (AMN) 产生的膜转移.
- 根据PSOGI的分类 (2016年) 将PMP分为非细胞性粘素 (AM),低度粘膜性癌 (LGMCP) 和高度粘膜性癌 (HGMCP).
- 准确的预后分层对于指导治疗和预测PMP患者的结果至关重要.
研究的目的:
- 评估PMP的PSOGI分类的长期预后意义.
- 为了确定腹转移的组织病理学等级是否预测了CRS+HIPEC后的生存结果.
- 评估腹组织学对整体存活率 (OS) 和无病存活率 (DFS) 的独立预测值.
主要方法:
- 在2006年至2021年期间接受CRS+HIPEC治疗的290名AMN的PMP患者的回顾性病理审查.
- 标准化监测协议适用于所有患者.
- 使用考克斯比例危险回归,日志等级测试和卡普兰-梅尔曲线进行了生存分析 (OS和DFS),按腹膜转移等级分层.
主要成果:
- 该队列包括34%的AM,59%的LGMCP和7%的HGMCP,随访时间中位数为49个月.
- 与AM相比,LGMCP和HGMCP的单变异分析显示,与AM相比,LGMCP和HGMCP的OS和DFS明显更差 (p < 0.001).
- 多变量分析证实HGMCP是糟糕的OS (HR:5.54,p=0.019) 的重要独立预测因素,而LGMCP没有显示出显著的关联.
结论:
- 根据PSOGI分类定义的腹转移组织病理等级是PMP患者的关键独立预后因素.
- 高度粘膜性周周癌 (HGMCP) 与CRS+HIPEC后的整体存活率显著降低有关.
- 这种分类有助于对PMP患者进行分层,并预测结果,而不管初级尾瘤组织学.
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