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胃高级别 T1 腺癌内镜切除术后的管理。

Management of high risk T1 gastric adenocarcinoma following endoscopic resection.

机构信息

Department of Gastroenterology, Porto Comprehensive Cancer Center, Porto, Portugal.

Department of Gastroenterology, Porto Comprehensive Cancer Center, Porto, Portugal; MEDCIDS- Department of Community, Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal.

出版信息

Best Pract Res Clin Gastroenterol. 2024 Feb;68:101887. doi: 10.1016/j.bpg.2024.101887. Epub 2024 Jan 30.

Abstract

Endoscopic submucosal dissection has revolutionized the treatment of early gastric cancer. However, cases that do not meet the curability criteria have a higher risk of lymph node metastasis and salvage surgery is still considered the next treatment approach to increase the chance of cure. Nevertheless, not all high-risk resections entail the same level of risk, emphasizing the utmost importance of individualized stratification for further treatment. In this review, we aim to examine the current evidence concerning the management following a high-risk non-curative resection, highlighting the existing approaches, while also presenting upcoming strategies that attempt to improve patient outcomes, minimize adverse events, and provide a tailored management.

摘要

内镜黏膜下剥离术已经彻底改变了早期胃癌的治疗方式。然而,不符合治愈标准的病例发生淋巴结转移的风险更高,挽救性手术仍然被认为是增加治愈机会的下一步治疗方法。然而,并非所有高危切除都存在相同水平的风险,这强调了进一步治疗进行个体化分层的重要性。在这篇综述中,我们旨在检查关于高危非治愈性切除后管理的现有证据,重点介绍现有的方法,同时介绍尝试改善患者预后、减少不良事件并提供个体化管理的新策略。

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