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原发性腹膜后黏液性囊腺癌(PRMCa):文献系统综述与荟萃分析

Primary retroperitoneal mucinous cystadenocarcinoma (PRMCa): a systematic review of the literature and meta-analysis.

作者信息

Myriokefalitaki E, Luqman I, Potdar N, Brown L, Steward W, Moss E L

机构信息

Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK.

Department of Pathology, University Hospitals of Leicester, Leicester, UK.

出版信息

Arch Gynecol Obstet. 2016 Apr;293(4):709-20. doi: 10.1007/s00404-015-3975-8. Epub 2015 Dec 17.

Abstract

PURPOSE

Primary retroperitoneal mucinous cystadenocarcinoma (PRMCa) is a rare tumour. Prognosis and optimal management are not well established. In view of a case managed in our Centre, we performed a systematic review and meta-analysis.

METHOD

Systematic review of medical electronic databases for published data (1950-12/10/2015). No RCTs identified. Individual patient data detracted from case reports and case series were analysed

RESULTS

In total, 73 female and 5 male cases of PRMCa identified including our case. Median age at diagnosis was 42.0 years (range 18-86 years), with women being significantly younger than men at diagnosis (42.0 years versus 62.2 years, p = 0.005). A palpable abdominal mass and abdominal pain were the most common presentations in 42.9 and 23.8 % of cases, respectively. Twenty-six women were <38 years old. There were 16 women <38 years old that had surgical data reported, of which 14 underwent fertility-sparing surgery with excision of the mass. Adjuvant chemotherapy was given in 24.1 % (13/72) women. Follow-up ranged from 1 to 130 months with a median of 15 months. Of the 57 cases that had follow-up reported, recurrence occurred in 23 cases (40.4 %) within a median of 8 months from diagnosis. Median disease-free survival was 15 months (range 1-130 months). Of the women who recurred, 14 died of their disease giving 1, 2 and 5-year disease-specific survival rates of 85.9, 80.7 and 75.4 %, respectively.

CONCLUSION

PRMCa are rare and potentially aggressive tumours that often occur in young women. Removal of the tumour, adequate staging and adjuvant chemotherapy needs to be considered.

摘要

目的

原发性腹膜后黏液性囊腺癌(PRMCa)是一种罕见肿瘤。其预后和最佳治疗方案尚未完全明确。鉴于我院中心诊治的一例病例,我们进行了一项系统综述和荟萃分析。

方法

对医学电子数据库(1950年至2015年10月12日)中已发表的数据进行系统综述。未检索到随机对照试验。对病例报告和病例系列中提取的个体患者数据进行分析。

结果

共纳入73例女性和5例男性PRMCa病例,包括我院的病例。诊断时的中位年龄为42.0岁(范围18 - 86岁),女性诊断时明显比男性年轻(42.0岁对62.2岁,p = 0.005)。可触及的腹部肿块和腹痛分别是42.9%和23.8%病例中最常见的表现。26名女性年龄小于38岁。有16名年龄小于38岁的女性报告了手术数据,其中14例行保留生育功能手术并切除肿块。24.1%(13/72)的女性接受了辅助化疗。随访时间为1至130个月,中位随访时间为15个月。在报告了随访情况的57例病例中,23例(40.4%)在诊断后中位8个月内复发。无病生存期的中位时间为15个月(范围1 - 130个月)。复发的女性中,14例死于该疾病,1年、2年和5年的疾病特异性生存率分别为85.9%、80.7%和75.4%。

结论

PRMCa是罕见且具有潜在侵袭性的肿瘤,常发生于年轻女性。需要考虑切除肿瘤、进行充分的分期评估以及辅助化疗。

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