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微创手术多学科团队在晚期及复发性妇科癌症中的应用:十年探索与实践

Application of Minimally Invasive Surgery-Multidisciplinary Team in Advanced and Recurrent Gynecological Cancers: 10-Year Exploration and Practice.

作者信息

Li Caixia, Wang Zhongjie, Yang Weihong, Ai Guihai, Cheng Zhongping

机构信息

Department of Gynecology and Obstetrics, Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Gynecol Minim Invasive Ther. 2022 Nov 7;12(3):141-147. doi: 10.4103/gmit.gmit_64_22. eCollection 2023 Jul-Sep.

Abstract

OBJECTIVES

The treatment of advanced and recurrent gynecological cancers (ARGCs) remains more difficult evens. This assay aims to introduce the application of minimally invasive surgery-multidisciplinary team (MIS-MDT) as well as a comprehensive evaluation and treatment program of ARGC.

MATERIALS AND METHODS

The diagnosis and treatment model of MDT collaboration has become a new model of clinical cancer treatment. In my country, it is in the start-up and trial stage. Our team began to explore surgical treatment of recurrent gynecological cancers in 2011 and has been committed to MDT treatment of ARGC for more than 3 years.

RESULTS

So far, 61 patients have completed MDT treatment (28 of them were advanced gynecological cancer patients, 33 of them were recurrent gynecological cancer patients). Among them, MDT involved 43 times in gastrointestinal surgery, 21 times in urology, 5 times in the department of intractable abdominal diseases, and 5 times in other departments. After surgery, 58 patients (95%) restarted adjuvant therapy such as radiotherapy and chemotherapy. In addition, 32 patients (52.5%) underwent genetic and molecular testing, of which 14 patients (23%) accepted targeted and immunotherapy based on the testing results. After MIS-MDT treatment, the median progression-free survival of these patients was >30 months, respectively.

CONCLUSION

These patients have achieved good results after surgery of MDT. With continuous accumulation and summarization, we have systematically reviewed the diagnosis and treatment model of ARGC and guided clinical work as the model of Tongji Tenth Hospital (comprehensive evaluation and treatment).

摘要

目的

晚期及复发性妇科癌症(ARGCs)的治疗仍然极具挑战性。本研究旨在介绍微创手术-多学科团队(MIS-MDT)的应用以及ARGC的综合评估与治疗方案。

材料与方法

MDT协作的诊断与治疗模式已成为临床癌症治疗的新模式。在我国,它正处于起步和试验阶段。我们团队于2011年开始探索复发性妇科癌症的手术治疗,并致力于ARGC的MDT治疗超过3年。

结果

截至目前,61例患者已完成MDT治疗(其中28例为晚期妇科癌症患者,33例为复发性妇科癌症患者)。其中,MDT涉及胃肠外科43次,泌尿外科21次,难治性腹部疾病科5次,其他科室5次。术后,58例患者(95%)重新开始放疗和化疗等辅助治疗。此外,32例患者(52.5%)接受了基因和分子检测,其中14例患者(23%)根据检测结果接受了靶向和免疫治疗。经过MIS-MDT治疗后,这些患者的中位无进展生存期分别>30个月。

结论

这些患者在MDT手术后取得了良好的效果。随着不断积累和总结,我们系统地回顾了ARGC的诊断和治疗模式,并以同济第十医院的模式(综合评估与治疗)指导临床工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8175/10553593/229dd6a0b933/GMIT-12-141-g001.jpg

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