[完全切除对大神经母细胞瘤患者生存的影响]
[Impact of complete resection on survival of patients with large neuroblastoma].
作者信息
Lobato R, Queizán A, Martínez L, Díaz M, Gámez M, Tovar J A
机构信息
Departamento de Cirugía Pediátrica, Hospital Infantil La Paz, Madrid.
出版信息
Cir Pediatr. 2000 Jan;13(1):14-5.
UNLABELLED
The aim of our study is to assess the role of complete resection after chemotherapy in stage 3 and 4 (INSS) neuroblastoma.
MATERIAL AND METHODS
We treated in the period 1990-1997 a group of 71 infants and children with neural tumors. There were 63 neuroblastomas (median age: 24.8 +/- 25 months, median 18). 47 were abdominal, 13 thoracic, 2 pelvic and 1 cervical. Survival rate (Kaplan-Meier) in patients with or without complete resection of the tumor were assessed (Mantel Cox).
RESULTS
14 of 17 patients with stage 3 tumors and only 8 of 23 with stage 4 survive. All patients with stage 3 undergoing complete resection are alive, whereas only 4 of 7 with incomplete resection survive (p < 0.01). In contrast, the effort and risk of resection do not appear to be worth in stage 4. Two kidneys, one spleen and a portion of the pancreas were removed to perform complete tumor removal.
CONCLUSIONS
Complete resection in stage 3 neuroblastoma after chemotherapy improves survival, and radical surgery seems justified even if neighboring structures have to be removed. Radical surgery does not seem to be useful in stage 4 neuroblastoma.
未标注
我们研究的目的是评估化疗后根治性切除在3期和4期（国际神经母细胞瘤分期系统）神经母细胞瘤中的作用。
材料与方法
1990年至1997年期间，我们治疗了一组71例患有神经肿瘤的婴幼儿和儿童。其中有63例神经母细胞瘤（中位年龄：24.8±25个月，中位数为18个月）。47例为腹部肿瘤，13例为胸部肿瘤，2例为盆腔肿瘤，1例为颈部肿瘤。评估了肿瘤完全切除或未完全切除患者的生存率（Kaplan-Meier法）（Mantel Cox检验）。
结果
17例3期肿瘤患者中有14例存活，23例4期肿瘤患者中仅有8例存活。所有接受根治性切除的3期患者均存活，而7例未完全切除的患者中仅有4例存活（p<0.01）。相比之下，4期患者进行切除手术的努力和风险似乎并不值得。为了完全切除肿瘤，切除了两个肾脏、一个脾脏和一部分胰腺。
结论
化疗后3期神经母细胞瘤的根治性切除可提高生存率，即使必须切除邻近结构，根治性手术似乎也是合理的。根治性手术对4期神经母细胞瘤似乎没有作用。
Zotero 插件