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关于治疗食道癌的ISDE指南cT2N0食道癌的管理
Geoffrey P Kohn1,2, Virginia Litle3, Yousif Eliya2
1Department of Surgery, Monash University, Melbourne, Vic, Australia.
概括
术后的新辅助疗法对cT2N0M0食道癌有条件推. 对于大多数患者来说,这种方法比初级手术切除更受青,改善了这个具有挑战性的阶段的治疗决策.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床指南 临床指南
背景情况:
- 全球食道癌发病率正在增加,这对公众健康构成了重大挑战.
- 精确的食道癌的手术前分期,特别是cT2N0M0疾病,尽管有先进的诊断工具,仍然很困难.
- 目前的管理指南为cT2N0M0食道癌提供了有限的具体指导,该癌症跨越了AJCCI和II阶段的分类.
研究的目的:
- 为最佳的手术前瘤管理提供基于证据的建议. cT2N0M0食道癌.
- 支持临床医生和患者为这种特定的食道癌阶段做出明智的治疗决策.
- 建立国际食道病学会 (ISDE) 关于管理食道癌症的指导方针.
主要方法:
- 由ISDE指南委员会工作组进行了系统的文献审查.
- 根据系统审查结果进行的专家小组讨论得到了利用.
- 使用推评估,开发和评估 (GRADE) 方法来制定推.
主要成果:
- 对cT2N0M0食道癌进行新辅助疗法,随后进行手术对初级手术切除 (PSR) 的有条件建议.
- 尽管在手术前分期存在挑战,但当使用现代分期技术时,在使用手术切除之后的新辅助疗法是最受青的.
- 对于无法耐受新辅助疗法或淋巴结转移风险非常低的患者,仍然可以考虑初级手术切除.
结论:
- 经过手术切除后的新辅助疗法代表了对cT2N0M0食道癌的首选治疗策略.
- 该指南旨在标准化和改进这种特定的食道癌亚组的管理.
- 个性化治疗决策应考虑患者的健康状况和瘤特异性风险因素.
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