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当前卵黄囊瘤的外科治疗趋势。

Current Trends in the Surgical Management of Yolk Sac Tumors.

机构信息

Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, Alfreda Sokołowskiego 11, 70-891 Szczecin, Poland.

Department of Thoracic Surgery, 'Attikon' University Hospital of Athens, 12462 Athens, Greece.

出版信息

Curr Oncol. 2024 Nov 6;31(11):6898-6908. doi: 10.3390/curroncol31110510.

Abstract

Mediastinal yolk sac tumors (YST) constitute a highly malignant subtype of primary non-seminomatous germ cell tumors, which are often locally advanced and unresectable at diagnosis. Due to their rarity and aggressiveness, there is not yet a standard optimal treatment approach. A widely employed multimodal strategy involves neoadjuvant cisplatin-based combination chemotherapy followed by consolidation surgery. Tumor infiltration into the lungs and adjacent cardiovascular structures is common, such that surgical intervention typically requires extensive resections, performed either by sternotomy or thoracotomy. For this review, we extensively searched the PubMed and Embase medical databases, identifying articles describing surgical treatment of mediastinal yolk sac tumors. The current literature provides limited details regarding the utilized surgical procedures, leaving clinicians without comprehensive guidance about the demanding nature of these resections. Here, we present a narrative description of the range of current surgical procedures. By highlighting these techniques, we provide a comprehensive overview of the current surgical landscape, thereby helping clinicians understand the potential complexities and considerations involved in managing these rare and aggressive tumors.

摘要

纵隔卵黄囊肿瘤(YST)构成了原发性非精原细胞瘤生殖细胞肿瘤的一种高度恶性亚型,这些肿瘤通常在诊断时局部晚期且无法切除。由于其罕见性和侵袭性,目前还没有标准的最佳治疗方法。一种广泛采用的多模式策略包括新辅助顺铂为基础的联合化疗,随后进行巩固性手术。肿瘤常浸润肺部和相邻的心血管结构,因此手术干预通常需要广泛的切除,通过胸骨切开术或开胸术进行。在本次综述中,我们广泛检索了 PubMed 和 Embase 医学数据库,以确定描述纵隔卵黄囊肿瘤手术治疗的文章。目前的文献对于所采用的手术程序提供的细节有限,使得临床医生对于这些切除的高难度性质缺乏全面的指导。在这里,我们对当前的手术程序进行了详细描述。通过强调这些技术,我们全面概述了当前的手术领域,从而帮助临床医生了解管理这些罕见和侵袭性肿瘤所涉及的潜在复杂性和注意事项。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/661a/11592850/1bc59c45a01d/curroncol-31-00510-g001.jpg

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