分期剖腹术在印度对霍奇金病的相关性。

The relevance of a staging laparotomy for Hodgkin's disease in India.

作者信息

Dinshaw K A, Pande S C, Shrivastava S K, Gonsalves M A, Advani S H, Gopal R, Shrikhande S S, Desouza L J, Jagannath P, Desai P B

机构信息

Department of Radiation Oncology, Tata Memorial Hospital, Bombay, India.

出版信息

J Surg Oncol. 1992 Jan;49(1):39-44. doi: 10.1002/jso.2930490110.

DOI:10.1002/jso.2930490110

PMID:1548880

Abstract

A retrospective analysis of 328 cases of Hodgkin's Disease (HD) subjected to a staging laparotomy at the Tata Memorial Hospital, Bombay, India, from 1974 to 1986 was undertaken to assess its relevance to our setup. Eighty percent of the patients were from clinical stages (CS) I and II, 38% with lymphocyte predominance (LP), and 41% with mixed cellularity (MC) histologies. Staging laparotomy was positive in 60% cases overall, including 50% from CS IA and IIA, 68% from CS IB and IIB, and 53% and 67%, respectively, from LP and MC histologies. Splenic involvement was seen in 54% cases. Operative complications were encountered in 2% of cases and deaths in two cases only. In view of the high propensity for abdominal spread, only selected CS IA and IIA cases would merit a staging laparotomy within which, nearly 50% cases with a negative yield could be offered radical segmental irradiation alone for cure. The majority of our patients would, however, require combination therapy.

摘要

对1974年至1986年期间在印度孟买塔塔纪念医院接受分期剖腹术的328例霍奇金病（HD）患者进行了回顾性分析，以评估其与我们医院情况的相关性。80%的患者处于临床I期和II期，38%为淋巴细胞为主型（LP），41%为混合细胞型（MC）组织学类型。分期剖腹术总体阳性率为60%，其中CS IA和IIA期患者阳性率为50%，CS IB和IIB期患者阳性率为68%，LP和MC组织学类型患者阳性率分别为53%和67%。54%的病例可见脾脏受累。2%的病例出现手术并发症，仅2例死亡。鉴于腹部扩散倾向较高，只有部分CS IA和IIA期病例值得进行分期剖腹术，其中近50%检查结果为阴性的病例可仅接受根治性节段放疗以治愈。然而，我们的大多数患者将需要联合治疗。