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JAMA Surg:黑色素瘤腹部转移的治疗与生存率:1969-2014

2017-04-07 MedSci MedSci原创

在全身系统治疗飞速发展的时代,手术切除仍然是一个有效的黑色素瘤治疗手段

在过去的十年中,转移性黑色素瘤全身系统治疗进展迅速,也使得病人的治疗策略抉择变得更加复杂。研究人员近日就黑色素瘤腹腔脏器转移患者采用全身系统治疗与手术切除治疗的生存率进行比较。

研究人员从约翰韦恩癌症研究所的数据库中获得了1969年至2014年共1632名腹腔脏器转移黑色素瘤患者资料,其中1969年至2003年间,患者全部进行的是潜在组织切除治疗而03年之后部分患者进行的是全身系统治疗,研究主要目的是比较二种方法的生存期。

在者1623名患者中,1097人为男性(67.6%),平均年龄54.6岁(SD 14.6),患者中有336人有胃肠道转移(20.7%)、697人有肝转移(42.9%)、138人有肾上腺转移(8.5%)、38人胰腺转移(2.3%)、109人脾转移(6.7%)、305人有多处转移(18.8%)。手术治疗(n=392)中位生存期优于非手术治(n=1231)疗18个月 vs 7个月;胃肠道或肝转移手术后1或2年生存率最高(胃肠道转移52%和41%,肝转移51%和38%);年龄增长以及溃疡的存在会减少患者生存期,进行切除手术或仅发生肠胃道转移会延长患者生存期;总体而言,胃肠道转移患者接受完整的,根治性切除手术获益最大,其中位数生存期为64个月。

研究表明,即使在全身系统治疗飞速发展的时代,手术切除仍然是一个有效的黑色素瘤治疗手段。

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