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Ann Oncol:早期手术切除可延长渗透性低级胶质瘤的生存期!

2017-05-08 MedSci MedSci原创

背景:渗透性低级胶质瘤(LGG; WHO 2级)通常存在于有癫痫发作史的年轻人中。 LGGs不断生长,通常转化为更高级别的恶性肿瘤,最终导致进行性残疾和过早死亡。前期手术的效果一直存在争议,且分子生物学对手术效果的影响是未知的。研究人员对比评估了前期手术切除术的长期结果和根据最近建立的分子标记物的观察等待方法的疗效。

背景:渗透性低级胶质瘤(LGG; WHO 2级)通常存在于有癫痫发作史的年轻人中。 LGGs不断生长,通常转化为更高级别的恶性肿瘤,最终导致进行性残疾和过早死亡。前期手术的效果一直存在争议,且分子生物学对手术效果的影响是未知的。研究人员对比评估了前期手术切除术的长期结果和根据最近建立的分子标记物的观察等待方法的疗效。

在挪威两个大学医院采用基于人口的平行队列,采用不同的手术治疗策略,并规定了地域集水区。在区域A期间,施行观察等待方法,而在区域B中实施早期切除术。因此,个体患者的治疗策略取决于他们的住址。数据被纳入的标准是1998年至2009年间18岁以上患者的上皮LGG的组织病理学诊断。随访结束于2016年1月1日。进行区域比较,获取的主要数据是总体生存期。

结果显示,153例患者(A区66例,B区87例)被纳入研究队列。 A区19例(29%)患者早期切除,B区75例(86%)患者进行早期切除。区域A的总生存期为5.8年(95%CI 4.5-7.2),而B区总生存期为14.4岁(95% CI 10.4-18.5)(P <0.01)。分子标记调整后手术策略的影响仍然存在(P = 0.001)。

结论:在平行的基于人群的LGGs队列中,早期手术切除增加临床相关的生存期限。调整分子标记后,对生存期的影响仍然存在。

原始出处:

A. S. Jakola, et al. Surgical resection versus watchful waiting in low-grade gliomas. Ann Oncol mdx230. DOI: https://doi.org/10.1093/annonc/mdx230

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