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Ann Thorac Surg:胸腺癌术中淋巴结清扫可使患者获益

2013-09-03 萧弈 dxy

对于肿瘤患者而言,淋巴结清扫在其手术中起着重要的作用。然而淋巴结清扫在胸腺癌中的作用方面数据仍比较缺乏。针对这种情况,来自韩国首尔国立大学医院的首尔国立大学医院In Kyu Park教授等人进行了一项研究,研究结果在线发表于2013年7月24日的《胸外科年鉴》(Annals of Surgical)杂志上。作者发现广泛的淋巴节清扫,10个以上淋巴结,才能准确地预测患者的预后。同时,前纵隔及右气管旁

对于肿瘤患者而言,淋巴结清扫在其手术中起着重要的作用。然而淋巴结清扫在胸腺癌中的作用方面数据仍比较缺乏。针对这种情况,来自韩国首尔国立大学医院的首尔国立大学医院In Kyu Park教授等人进行了一项研究,研究结果在线发表于2013年7月24日的《胸外科年鉴》(Ann Thorac Surg.)杂志上。作者发现广泛的淋巴节清扫,10个以上淋巴结,才能准确地预测患者的预后。同时,前纵隔及右气管旁淋巴结在胸腺癌术中应予以清扫。【原文下载

该研究回顾性分析37例完整切除的胸腺肿瘤。患者分为四组:无淋巴结清扫(NX)8例,病理N0部分淋巴结清扫(N0a)13例,病理N0广泛淋巴结清扫(N0b)10例,和淋巴结转移(N1)6例。对淋巴结清扫的结果进行了研究。无病生存率(DFS)和无复发率(FFR)四组进行了比较。

研究结果表明,29例患者共清扫了349个淋巴结。6例患者证实存在19个淋巴结转移,同时肿瘤侵及邻近器官。4例患者证实有前纵隔淋巴结节转移。3例证实有胸内淋巴结节转移,位于右气管旁淋巴结。11例患者复发(NX 2, N0a 4, N0b 1,N1 4)。5年总体生存率为65.5%,DFS为60.9%,FFR为68.2%。N0b亚组的DFS明显比N1亚组好(90%vs33.3%)。NX和N0a亚组的DFS相似(75%VS48.7%,P = 0.98),介于N0b和N1两组的预后之间。FFR分析证实了相同的结果。

该研究发现,对于胸腺癌患者广泛的淋巴节清扫, 10个以上淋巴结,才能准确地预测患者的预后。同时术中应进行前纵隔及右气管旁淋巴结清扫。
原始出处:

Park IK, Kim YT, Jeon JH, Kim HS, Hwang Y, Seong YW, Kang CH, Kim JH.Importance of lymph node dissection in thymic carcinoma.Ann Thorac Surg. 2013 Sep;96(3):1025-32 【原文下载

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    2014-03-20 yyj062
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    2013-09-05 sodoo
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