在不可切除/转移性细胞癌中推迟细胞还原性切除术:现实世界多中心回顾性研究
Ryuma Tanaka1, Masanao Shinohara2, Yohei Kawashima2
1Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
在转移性细胞癌 (mRCC) 中,推迟细胞还原性切除术 (dCN) 是可行的,并且与更好的生存结果有关. 很大一部分患者实现了持续的疾病控制,这表明了无需治疗的生存潜力.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 细胞还原性切除术 (CN) 在转移性细胞癌 (mRCC) 中的作用在系统疗法的进步中受到争议.
- 评估推迟CN (dCN) 提供了对其现实应用和患者结果的见解.
研究的目的:
- 确定接受dCN的mRCC患者的比例.
- 评估与dCN相关的瘤结果,包括无病生存率 (DFS) 和总生存率 (OS).
主要方法:
- 对278名符合条件的mRCC患者进行了回顾性审查,这些患者接受了一线氨酸激酶抑制剂 (TKI) 或免疫瘤学 (IO) 组合治疗.
- 患者被分为dCN和非切除组.
- 使用倾向分数匹配和多变量时间依赖的考克斯回归分析来比较结果.
主要成果:
- 大约20.9%的患者在系统治疗中位数为6.6个月后接受了dCN.
- 在匹配的队列中,dCN与改善的DFS (HR 0.38) 和OS (HR 0.19) 有显著的关联.
- 在27.6%的dCN患者中观察到术后并发症,没有4-5级事件;34.5%实现了无治疗的疾病控制.
结论:
- 延迟NC是选择的mRCC患者的可行方法,与延长存活相关.
- 需要进一步的前性试验来验证dCN的作用并优化患者选择标准.
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