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孟加拉国原发性气管癌的临床表现和多学科治疗方法:13 例患者的临床和治疗回顾。

Clinical Manifestation and Multidisciplinary Treatment Approaches for Primary Tracheal Carcinoma in Bangladesh: A Clinical and Therapeutic Review of 13 Patients.

机构信息

Department of Oncology, Bangladesh Specialized Hospital Limited, Dhaka, Bangladesh.

Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh.

出版信息

Cancer Rep (Hoboken). 2024 Aug;7(8):e2135. doi: 10.1002/cnr2.2135.

Abstract

BACKGROUND

Primary tracheal carcinoma is an exceptionally rare and life-threatening disease that presents significant diagnostic and therapeutic challenges. Delayed diagnosis due to misinterpretation of airway obstruction symptoms often leads to poorer prognoses for patients. This study aimed to explore the clinical manifestations and multidisciplinary treatment approaches for primary tracheal carcinoma in Bangladesh, with a focus on recent advancements in diagnosis and treatment.

METHODS

A retrospective observational study was conducted at Bangladesh Specialized Hospital Limited, involving patients aged over 30 who were diagnosed with tracheal carcinoma and underwent multidisiplinary treatment from July 2018 to June 2019. Data were collected through patient interviews and medical record reviews. Descriptive and inferential statistical analyses were performed to examine demographic characteristics, histological variations, tumor locations, clinical signs and symptoms, treatment approaches, and outcomes.

RESULTS

The study illuminated varied clinical presentations and the successful application of multidisciplinary approaches among the 13 patients. Invasive squamous cell carcinoma and adenoid cystic carcinoma were the predominant histological subtypes. Symptomatology, including dyspnea, cough, and hemoptysis, highlighted the challenge of early detection. Despite the rarity and intricacies associated with primary tracheal carcinoma, the multidisciplinary strategy yielded generally positive outcomes, as evidenced by a 1-year survival rate of 92.31% and a 5-year survival rate of 76.92%. Kaplan-Meier survival curves underscored the superior efficacy of surgical interventions over non-surgical approaches.

CONCLUSION

Despite some limitations, this study contributes crucial insights into the nuanced management of primary tracheal carcinoma in the Bangladeshi context. The demonstrated success of the multidisciplinary strategy, especially surgical interventions, accentuates the importance of definitive resection. The lone case of local recurrence emphasizes the necessity for vigilant follow-up.

摘要

背景

原发性气管癌是一种极为罕见且危及生命的疾病,在诊断和治疗方面存在重大挑战。由于对气道阻塞症状的误解导致诊断延迟,往往使患者的预后更差。本研究旨在探讨孟加拉国原发性气管癌的临床表现和多学科治疗方法,重点关注诊断和治疗方面的最新进展。

方法

在孟加拉国专科医院有限公司进行了一项回顾性观察性研究,纳入 2018 年 7 月至 2019 年 6 月期间年龄在 30 岁以上、经多学科治疗并被诊断为气管癌的患者。通过患者访谈和病历回顾收集数据。采用描述性和推断性统计分析方法,研究患者的人口统计学特征、组织学变异、肿瘤位置、临床症状和体征、治疗方法及结局。

结果

本研究揭示了 13 例患者的不同临床表现和多学科方法的成功应用。主要的组织学亚型为侵袭性鳞状细胞癌和腺样囊性癌。呼吸困难、咳嗽和咯血等症状突显了早期检测的挑战。尽管原发性气管癌罕见且复杂,但多学科策略总体上取得了积极的结果,1 年生存率为 92.31%,5 年生存率为 76.92%。Kaplan-Meier 生存曲线强调了手术干预优于非手术方法。

结论

尽管存在一些局限性,但本研究为孟加拉国原发性气管癌的精细化管理提供了重要见解。多学科策略,尤其是手术干预的成功应用,突出了明确切除的重要性。唯一的局部复发病例强调了需要进行密切随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f559/11331497/a7e3f2d16ed7/CNR2-7-e2135-g001.jpg

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