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美国国家癌症数据库:胸腔镜肺叶切除术是否能改善早期肺癌的长期预后?

2017-08-26 佚名 ioncology

根据美国国家癌症数据库的研究结果,I期非小细胞肺癌(NSCLC)患者接受电视辅助胸腔镜手术(VATS)肺叶切除术治疗,住院时间更短,且患者的长期生存率不低于开放肺叶切除术治疗者。

根据美国国家癌症数据库的研究结果,I期非小细胞肺癌(NSCLC)患者接受电视辅助胸腔镜手术(VATS)肺叶切除术治疗,住院时间更短,且患者的长期生存率不低于开放肺叶切除术治疗者。

美国北卡罗来纳州达勒姆的杜克大学医学中心Thomas a . D’amico医生的团队在T1-2,N0,M0 NSCLC患者中评估了逾7000例肺叶切除术(包括5566开放肺叶切除术和1548 VATS 手术)的长期生存和其他结果。

在52个月的中位随访期中,开放手术组的五年存活率为62.5%,VATS组为66.0%(P= 0.34)。在对1464名患者进行的倾向得分匹配分析中,开放手术组和VATS组在30天死亡率、30天再入院率、淋巴结分期上升率(nodal upstaging rate)和5年总生存上没有显着差异。VATS组的住院时间明显缩短(1天)。

D’Amico医生指出,“胸腔镜肺叶切除术的总成本也低于开放肺叶切除术(比机器人肺叶切除术要低得多)”。无共病亚组和≥11个淋巴结的亚组分析结果相似。D’Amico医生感慨道:“有趣的是,尽管关于VATS优势的证据已有很多,使用胸腔镜手术治疗早期肺癌的比例仍然较低,美国大约为50%,欧洲更低。真正限制胸腔镜手术应用的原因是,大多数患者无法找到技术专业的胸外科医生。”

土耳其卡尔斯Harakani州立医院的胸外科医生Zeynep Bilgi博士通过电子邮件告诉路透社:“VATS学习曲线并不是那么陡峭,只要有足够的病例数就可行。除非患者有一些特征使VATS手术不安全(肿瘤离切口很近,可能需要袖式切除,肿瘤大导致操作困难,胸壁侵润等),我们一般会选择做VATS手术。”

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  6. [GetPortalCommentsPageByObjectIdResponse(id=1876931, encodeId=24c018e69317a, 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=32, 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 Mar 26 09:37:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1645575, encodeId=b52e16455e550, content=<a href='/topic/show?id=79d99e04630' target=_blank style='color:#2F92EE;'>#长期预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97046, encryptionId=79d99e04630, topicName=长期预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0e4823226485, createdName=ymljack, createdTime=Tue Mar 06 11:37:00 CST 2018, time=2018-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1666167, encodeId=497c166616e85, content=<a href='/topic/show?id=5fd55943ecf' target=_blank style='color:#2F92EE;'>#早期肺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59437, encryptionId=5fd55943ecf, topicName=早期肺癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=592126038749, createdName=循证小兵, createdTime=Tue Oct 10 16:37:00 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1420078, encodeId=859214200e812, content=<a href='/topic/show?id=51208416264' target=_blank style='color:#2F92EE;'>#胸腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84162, encryptionId=51208416264, topicName=胸腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bb933558102, createdName=yinxm8304, createdTime=Mon Aug 28 01:37:00 CST 2017, time=2017-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556434, encodeId=a40d1556434de, content=<a href='/topic/show?id=a9b0820898c' target=_blank style='color:#2F92EE;'>#肺叶切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82089, encryptionId=a9b0820898c, topicName=肺叶切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=727d14772225, createdName=zhangj7113, createdTime=Mon Aug 28 01:37:00 CST 2017, time=2017-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237796, encodeId=4f3623e796fa, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Sun Aug 27 22:48:52 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237521, encodeId=02ee23e5215e, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Sun Aug 27 05:55:27 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237374, encodeId=2e5923e374f0, content=希望能彻底治疗癌症, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat Aug 26 12:51:25 CST 2017, time=2017-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237343, encodeId=76a823e34304, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/26/c8b491d4a115552789c06a0aff6346a7.jpg, createdBy=f1941967364, createdName=1e14ffd0m25(暂无匿称), createdTime=Sat Aug 26 10:44:42 CST 2017, time=2017-08-26, status=1, ipAttribution=)]
    2017-08-27 luominglian113

    学习了.谢谢分享

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1876931, encodeId=24c018e69317a, 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=32, 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 Mar 26 09:37:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1645575, encodeId=b52e16455e550, content=<a href='/topic/show?id=79d99e04630' target=_blank style='color:#2F92EE;'>#长期预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97046, encryptionId=79d99e04630, topicName=长期预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0e4823226485, createdName=ymljack, createdTime=Tue Mar 06 11:37:00 CST 2018, time=2018-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1666167, encodeId=497c166616e85, content=<a href='/topic/show?id=5fd55943ecf' target=_blank style='color:#2F92EE;'>#早期肺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59437, encryptionId=5fd55943ecf, topicName=早期肺癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=592126038749, createdName=循证小兵, createdTime=Tue Oct 10 16:37:00 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1420078, encodeId=859214200e812, content=<a href='/topic/show?id=51208416264' target=_blank style='color:#2F92EE;'>#胸腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84162, encryptionId=51208416264, topicName=胸腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bb933558102, createdName=yinxm8304, createdTime=Mon Aug 28 01:37:00 CST 2017, time=2017-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556434, encodeId=a40d1556434de, content=<a href='/topic/show?id=a9b0820898c' target=_blank style='color:#2F92EE;'>#肺叶切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82089, encryptionId=a9b0820898c, topicName=肺叶切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=727d14772225, createdName=zhangj7113, createdTime=Mon Aug 28 01:37:00 CST 2017, time=2017-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237796, encodeId=4f3623e796fa, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Sun Aug 27 22:48:52 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237521, encodeId=02ee23e5215e, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Sun Aug 27 05:55:27 CST 2017, time=2017-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237374, encodeId=2e5923e374f0, content=希望能彻底治疗癌症, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat Aug 26 12:51:25 CST 2017, time=2017-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=237343, encodeId=76a823e34304, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/26/c8b491d4a115552789c06a0aff6346a7.jpg, createdBy=f1941967364, createdName=1e14ffd0m25(暂无匿称), createdTime=Sat Aug 26 10:44:42 CST 2017, time=2017-08-26, status=1, ipAttribution=)]
    2017-08-27 大爰

    学习了谢谢分享!!

    0

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    2017-08-26 flysky120

    希望能彻底治疗癌症

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    2017-08-26 1e14ffd0m25(暂无匿称)

    学习学习

    0

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