Suppr超能文献

直肠癌患者术前短期放疗会导致切除标本中可检测到的淋巴结数量减少。

Short-term preoperative radiotherapy in rectal cancer patients leads to a reduction of the detectable number of lymph nodes in resection specimens.

作者信息

Maschuw K, Kress R, Ramaswamy A, Braun I, Langer P, Gerdes B

机构信息

Department of General Surgery, Philipps-University of Marburg, Baldingerstrasse, 35033, Marburg, Germany.

出版信息

Langenbecks Arch Surg. 2006 Aug;391(4):364-8. doi: 10.1007/s00423-006-0056-2. Epub 2006 May 9.

Abstract

BACKGROUND AND AIMS

The Union Internationale Contre le Cancer and American Joint Committee on Cancer classification propose that pN(0)-classified colorectal lymphadenectomy specimens will ordinarily include 12 or more tumor-negative lymph nodes. We performed a clinical trial to investigate whether a short-term preoperative radiotherapy (5x5 Gy) leads to a reduction of the number of lymph nodes in rectal cancer specimens after total and partial mesorectal excision (TME and PME, respectively).

MATERIALS AND METHODS

Within a 5-year period, 28 (15%) of 148 rectal cancer patients underwent hypofractionated preoperative radiotherapy in this monocenter study, whereas 120 patients (85%) underwent TME/PME surgery alone. The main criterion was the number of lymph nodes in TME/PME specimens. We used a stratified one-sided Wilcoxon-Mann-Whitney test to test for a significant difference in the number of lymph nodes, stratifying for tumor location and postoperative tumor stage. Patients who were suspected of having any alterations in the number of pelvic lymph nodes were excluded from the study.

RESULTS

Fewer lymph nodes were detected in the TME/PME specimens of patients who received hypofractionated preoperative radiotherapy compared to patients who underwent TME/PME surgery alone (12 detectable lymph nodes vs 15; p=0.0005). Tumor location (p=0.095) and tumor stage (p=0.093) did not significantly influence the number of lymph nodes in this study.

CONCLUSIONS

We conclude that a 5x5 Gy short-term preoperative radiotherapy leads to a reduction in the number of lymph nodes in TME/PME specimens. Because neoadjuvant therapy in rectal cancer for T(2) and T(3) tumors has advanced a new therapeutic standard procedure, in the future, less lymph nodes will be detected in TME/PME specimens. This might influence the required number of lymph nodes in current staging systems for rectal cancer in the future.

摘要

背景与目的

国际抗癌联盟和美国癌症联合委员会的分类方法提出,pN(0)分类的结直肠淋巴结清扫标本通常应包含12个或更多肿瘤阴性淋巴结。我们开展了一项临床试验,以研究短期术前放疗(5×5 Gy)是否会使全直肠系膜切除(TME)和部分直肠系膜切除(PME)术后直肠癌标本中的淋巴结数量减少。

材料与方法

在一项单中心研究中,148例直肠癌患者中有28例(15%)在5年期间接受了短程术前放疗,而120例患者(85%)仅接受了TME/PME手术。主要标准是TME/PME标本中的淋巴结数量。我们采用分层单侧Wilcoxon-Mann-Whitney检验来检测淋巴结数量的显著差异,并根据肿瘤位置和术后肿瘤分期进行分层。怀疑盆腔淋巴结数量有任何改变的患者被排除在研究之外。

结果

与仅接受TME/PME手术的患者相比,接受短程术前放疗的患者的TME/PME标本中检测到的淋巴结较少(可检测到的淋巴结为12个对15个;p=0.0005)。在本研究中,肿瘤位置(p=0.095)和肿瘤分期(p=0.093)对淋巴结数量没有显著影响。

结论

我们得出结论,5×5 Gy的短期术前放疗可使TME/PME标本中的淋巴结数量减少。由于T(2)和T(3)期直肠癌的新辅助治疗已推进了一种新的治疗标准程序,未来在TME/PME标本中检测到的淋巴结将减少。这可能会影响未来直肠癌当前分期系统中所需淋巴结的数量。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验