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Clin Trans Gastroenterology: 高危T1型大肠癌患者术前行内镜切除术不会影响术后复发率

2021-12-28 MedSci原创 MedSci原创

有淋巴结转移(LNM)的T1型大肠癌(CRC)可以通过内镜切除术(ER)进行治疗,而无需额外手术。但是T1 CRC的组织学的深度> 1,000μm或具有淋巴管浸润阳性的组织学特征不佳的患者

有淋巴结转移(LNM)的T1型大肠癌(CRC)可以通过内镜切除术(ER)进行治疗,而无需额外手术。但是T1 CRC的组织学的深度> 1,000μm或具有淋巴管浸润阳性的组织学特征不佳的患者,建议通过二次手术(SS)进行其他治疗,以避免淋巴结的远处转移。一些研究表明,对T1 CRC的内镜治疗不会加速CRC的恶变。考虑到淋巴结转移的风险,内镜切除术(ER)后患有高风险的T1大肠直肠癌(CRC)的患者应进行额外的手术治疗。尽管额外的手术可以潜在地预防复发,但仍缺乏数据和纵向研究来探讨这种影响。因此,本研究旨在评估ER手术对T1 CRC复发的长期影响。

 




研究人员收集了在2004年1月至2015年10月之间的162例接受ER后的二次手术(SS)的患者([ER + SS]组)和392例接受T1 CRC的首次手术的患者,分析这两组的复发情况。根据日本结肠癌和直肠癌学会指南(2016)对高危CRC患者进行了组织学定义,以进行CRC的后续治疗。

 




研究结果显示ER + SS组与原发手术组的复发率相当,无显着差异(P = 0.625)。两组接受辅助化疗的患者的复发率均无显着差异(7.4%vs 10.4%,P = 0.27)。两组的平均淋巴结数目差异也不显着(24.3 vs 25.3,P = 0.43)。

 



图:术前接受ER治疗对于术后预后的影响

 


因此,作者证实对于高危T1 CRC,术前接受ER治疗的患者与接受初次手术的患者之间的复发率无显着差异。ER对于高风险的T1 CRC是可以接受的。




原始出处:
Takamaru, Hiroyuki. Et al. Endoscopic Resection Before Surgery Does Not Affect the Recurrence Rate in Patients With High-Risk T1 Colorectal Cancer. Clinical and Translational Gastroenterology.2021.

 

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    2022-06-05 许安
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topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sat May 28 08:03:49 CST 2022, time=2022-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922446, encodeId=ab88192244660, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Mon May 23 10:03:49 CST 2022, time=2022-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657592, encodeId=4649165e592bd, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, 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time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505364, encodeId=a14b150536443, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Thu Dec 30 08:03:49 CST 2021, time=2021-12-30, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2073496, encodeId=ab1520e34961d, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Jun 05 02:03:49 CST 2022, time=2022-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712993, encodeId=024e1e129930b, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, 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time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505364, encodeId=a14b150536443, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Thu Dec 30 08:03:49 CST 2021, time=2021-12-30, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2073496, encodeId=ab1520e34961d, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Jun 05 02:03:49 CST 2022, time=2022-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712993, encodeId=024e1e129930b, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, 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encodeId=dfe318e753191, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Mon Sep 19 20:03:49 CST 2022, time=2022-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262271, encodeId=b6de12622e157, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Dec 30 08:03:49 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505364, encodeId=a14b150536443, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Thu Dec 30 08:03:49 CST 2021, time=2021-12-30, status=1, ipAttribution=)]
    2022-05-19 bsmagic9140
  7. 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