淋巴结产量及其对生存结果的影响:来自丹麦的回顾性多中心队列研究
Oliver Nørholm Kempf1, Lise Bech Jellesmark Thorsen2, Nikolaj Nerup1
1Department of Digestive Diseases, Transplantation and General Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
概括
更高的淋巴结 (LN) 产量提高了节点阴性食道癌患者的生存率. 对于结节阳性食道癌和胃癌,生存效益高原超出了16-19个淋巴结被移除.
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:
- 淋巴结 (LN) 产量的预后意义在食道和胃癌手术中受到争议,特别是在不断发展的外科手术治疗中.
- 精确的分期和适当的LN剖析对于预测上部胃肠道癌症的结果至关重要.
研究的目的:
- 为了研究淋巴结产量与食道癌和胃癌患者的生存结果之间的关联进行治疗切除.
- 根据结节状况和LN产量评估术后化疗对生存的影响.
主要方法:
- 在2013-2021年期间,对3092名患有食道癌 (n=2402) 或胃癌 (n=690) 的患者进行了多中心队列研究.
- 使用了丹麦食管胃癌组数据库,确保了全面的数据覆盖.
- 采用卡普兰-梅尔曲线和多变量考克斯回归来进行生存分析,按节点状态和LN产量分层.
主要成果:
- 在节点阴性食道癌症中,较高的LN产量 (≥20) 与16-19节点的产量相比显著与改善的生存率有关.
- 对于节点阳性食道癌或胃癌,LN产量超过16-19节点,没有观察到显著的生存益处.
- 周围手术化疗改善了节点阳性食道癌的存活率,但不是节点阴性食道或胃癌. 临床和病理结节阶段之间经常存在差异.
结论:
- 淋巴结产量是一个显著的预后因素,特别是在节点阴性食道癌症中,去除≥20个节点可以提高存活率.
- 对于节点阳性食道癌和胃癌,LN产量的生存益处在16-19节点后似乎趋于平稳.
- 节点分期的差异凸显了改善术前诊断的需要,并强调了术后化疗对治疗分配和结果的影响.
相关概念视频
01:15Secondary Lymphoid Organs
7.2K
Secondary organs, including lymph nodes, the spleen, and mucosa-associated lymphoid tissue (MALT), work harmoniously to protect us from disease and infection.
The spleen is a vital organ in the lymphatic system, nestled in the upper left side of the abdomen. It is composed of two primary regions: the red pulp and the white pulp, each having distinct functions. The red pulp performs a significant role in blood filtration. It efficiently purges the blood of old or damaged red blood cells and...
The spleen is a vital organ in the lymphatic system, nestled in the upper left side of the abdomen. It is composed of two primary regions: the red pulp and the white pulp, each having distinct functions. The red pulp performs a significant role in blood filtration. It efficiently purges the blood of old or damaged red blood cells and...
7.2K
01:23Detailed Structure and Function of Lymph Nodes
13.4K
Lymph nodes are bean-shaped structures that cluster along the lymphatic vessels in the inguinal, axillary, and cervical regions. Each node is divided into compartments by a capsule that extends trabeculae inward.
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
13.4K
01:21Cancer Survival Analysis
863
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
863