在恶性结肠直肠多重切除术后,具有高风险特征的立即手术或非手术管理后,残留癌症的风险
Thikhamporn Tawantanakorn1, A Begum Bektas2, Matthew Hill1
1Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
JCO oncology advances
|February 25, 2026
概括
对于具有高风险特征的恶性息肉,近20%的患者有残留疾病. 非手术治疗是一种选择,对于那些避免立即手术的人来说,可提供有效的救援治疗.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 国家指导方针建议对具有高风险特征的恶性息肉进行结直肠切除.
- 一些患者由于患病率和生活质量问题而避免手术,尽管存在残留疾病风险.
研究的目的:
- 为了比较高风险恶性息肉患者的残留疾病率,这些患者接受了立即手术与非手术治疗.
- 为患者咨询提供有关手术风险和非手术监测选项的信息.
主要方法:
- 回顾性单中心队列研究 (2015-2022年).
- 立即手术 (n=208) 和非手术治疗 (n=128) 组之间的残留疾病率比较.
- 患者曾经接受过针对具有高风险特征的恶性息肉的多角切除术.
主要成果:
- 总体残留疾病率为19% (63/336名患者).
- 立即手术组:25%的残留疾病 (肠壁,淋巴结).
- 非手术组:9%在监测期间复发,所有人都成功地接受了救援疗法.
结论:
- 具有高风险特征的恶性聚被切除后,残留疾病的风险是相当大的 (约. 20%). 这是一个很好的方法.
- 非手术治疗是一种可行的选择,有有效的救援治疗方法可用.
- 患者应获得有关风险,益处和立即手术的替代方案的建议.
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