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IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-17 DOI: 10.1016/S0748-7983(24)00731-5

引用次数: 0

Effect of postoperative normothermic intraperitoneal chemotherapy on the prognosis of MPM patients receiving CRS+HIPEC: A single-center case-control study 术后常温腹腔化疗对接受CRS+HIPEC治疗的MPM患者预后的影响：单中心病例对照研究

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-14 DOI: 10.1016/j.ejso.2024.108692

Background

The comprehensive treatment strategy, mainly cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC), combined with systemic and intraperitoneal chemotherapy, is the standard treatment for malignant peritoneal mesothelioma (MPM), which can significantly prolong the survival of patients. The aim of this study is to investigate the clinical significance of postoperative normothermic intraperitoneal chemotherapy (NIPEC) in MPM patients.

Methods

Data of 152 MPM patients who underwent CRS + HIPEC and postoperative intravenous chemotherapy were retrospectively analyzed. Patients were divided into the Non-NIPEC group and the NIPEC group according to whether they received NIPEC after surgery. The baseline characteristics of the two groups were compared, and the survival outcome was analyzed in subgroups according to completeness of cytoreduction (CC) score. Multivariate survival analysis was used to determine the independent prognostic factors.

Results

In CC 0–1 and CC 2–3 subgroups, there was no significant difference in baseline characteristics between Non-NIPEC and NIPEC groups. Survival analysis showed that for CC 0–1 patients, there was no significant difference in overall survival (OS) between Non-NIPEC and NIPEC groups (P = 0.503). However, for CC 2–3 patients, the median OS of the NIPEC group was significantly longer than that of the Non-NIPEC group (24.5 vs. 10.3 months, P = 0.005). Pathological type, preoperative thrombosis and postoperative NIPEC (HR = 0.423, 95%CI: 0.228–0.786, P = 0.006) were independent prognostic factors for CC 2–3 patients.

Conclusions

For MPM patients receiving CRS + HIPEC, postoperative intraperitoneal combined with intravenous chemotherapy may improve the survival of CC 2–3 patients, but CC 0–1 patients do not seem to derive the same benefit.

背景以细胞减灭术（CRS）加腹腔内热化疗（HIPEC）为主，结合全身化疗和腹腔内化疗的综合治疗策略是恶性腹膜间皮瘤（MPM）的标准治疗方法，可显著延长患者的生存期。本研究旨在探讨 MPM 患者术后常温腹腔化疗（NIPEC）的临床意义。方法回顾性分析了 152 例接受 CRS + HIPEC 和术后静脉化疗的 MPM 患者的数据。根据患者术后是否接受 NIPEC，将其分为非 NIPEC 组和 NIPEC 组。比较了两组患者的基线特征，并根据细胞减灭完整性（CC）评分进行了亚组生存结果分析。结果在 CC 0-1 和 CC 2-3 亚组中，非 NIPEC 组和 NIPEC 组的基线特征无显著差异。生存期分析表明，对于 CC 0-1 患者，非 NIPEC 组和 NIPEC 组的总生存期（OS）无明显差异（P = 0.503）。然而，对于CC 2-3患者，NIPEC组的中位生存期明显长于非NIPEC组（24.5个月对10.3个月，P = 0.005）。病理类型、术前血栓形成和术后 NIPEC（HR = 0.423，95%CI：0.228-0.786，P = 0.006）是 CC 2-3 患者的独立预后因素。

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引用次数: 0

Letter to the editor: Transforming cancer care: The vital role of prehabilitation in colorectal surgery 致编辑的信转变癌症护理：结直肠手术前康复的重要作用

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-14 DOI: 10.1016/j.ejso.2024.108694

引用次数: 0

Preoperative geriatric assessment to predict functional outcome after major urologic operations: Results from a multicenter study 通过术前老年病学评估预测泌尿外科大手术后的功能预后：一项多中心研究的结果

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-14 DOI: 10.1016/j.ejso.2024.108693

Introduction

Major urological tumor surgery entails a severe risk of unexpected adverse events, persistent functional deterioration, and death in older patients. The Erlangen Index (EI) geriatric assessment tool has previously been shown to predict incomplete functional recovery following major urological tumor surgery in an elderly patient collective. We prospectively evaluated assessment tools including EI in a multicenter setting.

Materials and methods

A total of 340 patients over the age of 65 were assessed prospectively before and after cystectomy, prostatectomy, or renal tumor surgery at three academic centers in Germany and Austria. Endpoints were long-term functional deterioration (Activities of daily living (ADL) measured by Barthel-Index) at day 30 and day 180, and mortality at day 180.

Results

In this study 58 (17.0 %) patients underwent cystectomy, 140 (41.2 %) prostatectomy and 142 (41.8 %) a kidney tumor operation. Mean age was 74.8 years. ADL impairment as a measure of incomplete recovery at day 30 and 180 after surgery were recorded in 47.6 % and 37.4 % of cases, respectively. The EI showed good sensitivity for mortality at day 180 (reference cohort: 85 %, validation center 1: 100 %, validation center 2: 50 %) and for ADL impairment at day 180 (reference cohort 75.4 %, validation center 1 72.3 %, validation center 2 83.3 %).

Conclusion

Elderly patients with a poor performance status have a high risk of persistent functional deterioration. Data from this multicenter external validation trial confirms the EI as an accurate and reliable tool to identify patients with high risk of mortality or persistent postoperative functional impairment.

导言：泌尿系统肿瘤大手术对于老年患者来说，存在发生意外不良事件、功能持续恶化和死亡的严重风险。埃尔朗根指数（EI）老年评估工具曾被证明可以预测老年患者在泌尿系统肿瘤大手术后功能恢复不完全的情况。我们在多中心环境中对包括 EI 在内的评估工具进行了前瞻性评估。材料和方法在德国和奥地利的三个学术中心对 340 名 65 岁以上的患者进行了膀胱切除术、前列腺切除术或肾肿瘤手术前后的前瞻性评估。终点是第 30 天和第 180 天的长期功能衰退（日常生活活动能力（ADL）以 Barthel 指数衡量）和第 180 天的死亡率。结果在这项研究中，58 名（17.0%）患者接受了膀胱切除术，140 名（41.2%）患者接受了前列腺切除术，142 名（41.8%）患者接受了肾肿瘤手术。平均年龄为 74.8 岁。术后第 30 天和第 180 天，分别有 47.6% 和 37.4% 的病例出现 ADL 功能障碍，作为未完全康复的衡量标准。EI 对第 180 天的死亡率（参考队列：85%；验证中心 1：100%；验证中心 2：50%）和第 180 天的 ADL 损伤（参考队列：75.4%；验证中心 1：72.3%；验证中心 2：83.3%）显示出良好的灵敏度。这项多中心外部验证试验的数据证实，EI 是一种准确可靠的工具，可用于识别死亡风险高或术后功能持续受损的患者。

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引用次数: 0

Multidisciplinary team meetings and their impact on survival in rectal cancer. Population-based analysis in Catalonia (Spain) 多学科团队会议及其对直肠癌患者生存率的影响。加泰罗尼亚（西班牙）的人群分析

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-12 DOI: 10.1016/j.ejso.2024.108675

Background

Multidisciplinary team meetings (MTMs) are considered a pillar of cancer care; however, evidence of the independent benefit of MTMs on survival in rectal cancer is controversial.

Methods

This population-based cohort analysis included patients undergoing surgery for primary rectal cancer with curative intent. We drew data derived from three clinical audits conducted in Catalonia from 2011 to 2020. The primary outcome was 2-year survival. Multivariable Cox regression analysis was used to assess the hazard ratio for death in patients whose cases were versus were not discussed in a preoperative MTM.

Results

A total of 5249 patients were included (66.1 % male, 58.3 % aged 60–79 years, 63.2 % receiving anterior resection): 4096 cases were discussed in a preoperative MTM, and 1153 were not. Multivariable Cox proportional hazards regression analysis showed that the MTM group had better survival than those with no preoperative MTM (hazard ratio 1.22, 95 % confidence interval 1.02–1.48), after adjusting for potential confounders.

Conclusions

Preoperative MTM may be associated with improved survival in patients with rectal cancer in Catalonia. Efforts to ensure universal access to MTMs for all newly diagnosed patients should be supported.

背景多学科团队会议（MTMs）被认为是癌症护理的支柱；然而，MTMs 对直肠癌患者生存率的独立益处的证据尚存争议。我们从 2011 年至 2020 年在加泰罗尼亚进行的三次临床审计中提取了数据。主要结果是两年生存率。我们使用多变量 Cox 回归分析来评估术前 MTM 讨论与未讨论病例患者的死亡危险比。结果共纳入 5249 例患者（66.1% 为男性，58.3% 年龄在 60-79 岁之间，63.2% 接受前切除术）：4096例患者在术前进行了MTM讨论，1153例未进行MTM讨论。多变量考克斯比例危险回归分析显示，在调整了潜在的混杂因素后，术前 MTM 组的生存率高于未进行术前 MTM 的患者（危险比为 1.22，95% 置信区间为 1.02-1.48）。应支持确保所有新确诊患者都能接受 MTM 的努力。

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引用次数: 0

Perioperative blood transfusions associated with reduced survival in gastroesophageal cancers – A Swedish population-based study 围手术期输血与胃食管癌患者生存率降低有关--一项基于瑞典人群的研究

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-12 DOI: 10.1016/j.ejso.2024.108690

Background

Blood transfusion has been associated with decreased long-term survival in cancer patients, possibly due to various immunological factors. We aimed to evaluate if perioperative transfusions decrease survival in patients who undergo resection for esophageal or gastric cancer and to identify factors associated with such events.

Methods

A population-based cohort study was conducted based on the Swedish National Registry for Esophageal and Gastric Cancer, which prospectively collects clinical data of patients with these tumors. Almost all patients (96 %) resected for esophageal or gastric cancer in Sweden between 2017 and 2022 were included. Survival data were acquired from the Swedish Cause of Death Registry. Multivariable Cox regression was used to calculate hazard ratios (HR) with 95 % confidence intervals (CI), adjusted for age, fitness, neoadjuvant therapy, surgical access, and pathological TNM stage.

Results

Of all 1365 patients, 227 (17 %) received perioperative transfusions. Transfusion was associated with an increased risk of all-cause mortality within 3 years of surgery (adjusted HR 1.50, 95 % CI 1.17–1.91). To exclude the influence of surgery-related postoperative complications, a sensitivity analysis was performed excluding patients who died within 30 days of resection and the negative impact of transfusions on 3-year mortality remained (adjusted HR 1.30, 95 % CI 1.01–1.68). Increasing age, open surgery, esophagectomy, perioperative bleeding, and nodal tumor involvement were all associated with an increased likelihood of receiving transfusions.

Conclusion

Perioperative blood transfusions might have a negative impact on 3-year survival in patients who undergo surgery for esophageal or gastric cancer.

背景输血与癌症患者长期生存率下降有关，这可能是由于各种免疫因素造成的。我们的目的是评估围手术期输血是否会降低食管癌或胃癌切除术患者的生存率，并确定与此类事件相关的因素。方法我们在瑞典食管癌和胃癌国家登记处的基础上开展了一项基于人群的队列研究，该登记处前瞻性地收集了这些肿瘤患者的临床数据。研究纳入了2017年至2022年期间在瑞典接受食管癌或胃癌切除术的几乎所有患者（96%）。生存数据来自瑞典死因登记处。结果在所有1365名患者中，227人（17%）接受了围手术期输血。输血与术后 3 年内全因死亡风险增加有关（调整后 HR 1.50，95 % CI 1.17-1.91）。为了排除手术相关术后并发症的影响，我们进行了一项敏感性分析，排除了切除术后 30 天内死亡的患者，结果发现输血对 3 年死亡率的负面影响依然存在（调整后 HR 1.30，95 % CI 1.01-1.68）。年龄增加、开放手术、食管切除术、围手术期出血和结节肿瘤受累都与接受输血的可能性增加有关。

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引用次数: 0

Prehab, ERAS, Rehab: A patient care continuum around colo-rectal surgery 康复前、ERAS、康复：结肠直肠手术患者护理的连续性

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-12 DOI: 10.1016/j.ejso.2024.108688

Background

Prehabilitation (Prehab) programs aim to optimize patients psycho-physical condition before surgery, to improve post-operative outcomes. Although functional benefits of Prehab are known, the clinical impact does not yet have concrete evidence. The objective of this study is to evaluate the efficacy of Prehab, associated with Enhanced Recovery After Surgery (ERAS) and surgical rehabilitation (Rehab), in frail colorectal oncological patients in terms of morbidity and hospitalization.

Patients and methods

The cohort of patients undergoing Prehab between January 2020 and December 2022 (Prehab group) is compared with the historical cohort of patients operated on in the period 01/2018-12/2019, not undergoing Prehab (no-Prehab group). Prehab scheme: multimodal (physiotherapy, clinical nutrition and psychological support). All patients followed an ERAS path. Only Prehab patients followed a surgical Rehab by a dedicated nurse case-manager. Propensity score matching (PSM) and weighting (PSW) analyses were used for statistical analysis. Primary objectives: complications at 30 days and hospital stay. Secondary objectives: functional outcomes.

Results

In 3 years of preliminary enrollment, 36 patients completed the program: 22 in person, 16 in tele-prehab. The Prehab group experienced fewer complications than the no-Prehab group (PSM: 31 % vs 53 % p = 0.02; PSW: 31 % vs 51 % p = 0.02), less severe complications (CCI>20 PSM: 17 % vs 33 % p = 0.074; PSW: 17 % vs 53 % 0.026) and shorter hospital stay (4.5 vs 6 days; p = 0.02). Finally, prehabilitated patients improved their preoperative functional capacity and reduced anxiety levels.

Conclusion

The strategy of combining Prehab with ERAS and Rehab has positively influenced post-operative clinical outcomes as well as functional parameters in our series.

背景康复前（Prehab）计划旨在优化患者术前的心理和生理状况，以改善术后效果。虽然康复前训练的功能性益处已众所周知，但其临床影响尚无具体证据。本研究的目的是评估与术后增强康复（ERAS）和手术康复（Rehab）相关的预康复在体弱结直肠肿瘤患者的发病率和住院率方面的疗效。患者和方法将2020年1月至2022年12月期间接受预康复的患者队列（预康复组）与2018年1月至2019年12月期间接受手术但未接受预康复的历史患者队列（未接受预康复组）进行比较。康复前计划：多模式（物理治疗、临床营养和心理支持）。所有患者均采用ERAS路径。只有康复前患者在专职护士病例管理员的指导下进行手术康复。统计分析采用倾向得分匹配（PSM）和加权（PSW）分析。首要目标：30 天的并发症和住院时间。次要目标：功能结果。结果在初步注册的 3 年中，有 36 名患者完成了该计划：在初步注册的 3 年中，有 36 名患者完成了该计划：22 人亲自参加，16 人参加了远程预康复。康复前组的并发症少于无康复前组（PSM：31 % vs 53 % p = 0.02；PSW：31 % vs 51 % p = 0.02），严重并发症少（CCI>20 PSM：17 % vs 33 % p = 0.074；PSW：17 % vs 53 % 0.026），住院时间短（4.5 天 vs 6 天；p = 0.02）。最后，康复前患者提高了术前功能能力，降低了焦虑水平。结论在我们的系列研究中，将康复前治疗与 ERAS 和康复治疗相结合的策略对术后临床结果和功能参数产生了积极影响。

{"title":"Prehab, ERAS, Rehab: A patient care continuum around colo-rectal surgery","authors":"","doi":"10.1016/j.ejso.2024.108688","DOIUrl":"10.1016/j.ejso.2024.108688","url":null,"abstract":"<div><h3>Background</h3><p>Prehabilitation (Prehab) programs aim to optimize patients psycho-physical condition before surgery, to improve post-operative outcomes. Although functional benefits of Prehab are known, the clinical impact does not yet have concrete evidence. The objective of this study is to evaluate the efficacy of Prehab, associated with Enhanced Recovery After Surgery (ERAS) and surgical rehabilitation (Rehab), in frail colorectal oncological patients in terms of morbidity and hospitalization.</p></div><div><h3>Patients and methods</h3><p>The cohort of patients undergoing Prehab between January 2020 and December 2022 (Prehab group) is compared with the historical cohort of patients operated on in the period 01/2018-12/2019, not undergoing Prehab (no-Prehab group). Prehab scheme: multimodal (physiotherapy, clinical nutrition and psychological support). All patients followed an ERAS path. Only Prehab patients followed a surgical Rehab by a dedicated nurse case-manager. Propensity score matching (PSM) and weighting (PSW) analyses were used for statistical analysis. Primary objectives: complications at 30 days and hospital stay. Secondary objectives: functional outcomes.</p></div><div><h3>Results</h3><p>In 3 years of preliminary enrollment, 36 patients completed the program: 22 in person, 16 in tele-prehab. The Prehab group experienced fewer complications than the no-Prehab group (PSM: 31 % vs 53 % p = 0.02; PSW: 31 % vs 51 % p = 0.02), less severe complications (CCI>20 PSM: 17 % vs 33 % p = 0.074; PSW: 17 % vs 53 % 0.026) and shorter hospital stay (4.5 vs 6 days; p = 0.02). Finally, prehabilitated patients improved their preoperative functional capacity and reduced anxiety levels.</p></div><div><h3>Conclusion</h3><p>The strategy of combining Prehab with ERAS and Rehab has positively influenced post-operative clinical outcomes as well as functional parameters in our series.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Differences in characteristics and outcomes between early-onset colorectal cancer and late-onset colorectal cancers 早发结直肠癌和晚发结直肠癌的特征和预后差异

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-11 DOI: 10.1016/j.ejso.2024.108687

Introduction

Colorectal cancer (CRC) represents a significant health burden worldwide, with a notable increase in early-onset colorectal cancer (EOCRC) cases, defined as those diagnosed before the age of 50 years.

Materials and methods

Using data from Taiwan's national cancer registry and a retrospective cohort from Chang Gung Memorial Hospital, this study analyzed CRC cases diagnosed between 2008 and 2019. The analysis compared the EOCRC and late-onset CRC (LOCRC) groups in terms of clinicopathological characteristics, pre-diagnostic symptoms, and survival outcomes.

Results

The analysis revealed a continuous increase in the annual incidence of EOCRC, with colon cancer and rectal cancer rising by 3.2 % and 3.3 %, respectively. Patients with EOCRC presented with more aggressive disease characteristics, such as signet-ring cell adenocarcinoma, mucinous adenocarcinoma, and poorly differentiated grade. Advanced stages at diagnosis, stages III and IV, were more common with EOCRC (62.4 %) than with LOCRC (50.3 %). Patients with EOCRC reported rectal bleeding, changes in bowel habits, and abdominal pain more frequently than those in the LOCRC group. There is a strong association between stool-related symptoms and left-sided CRC. Despite similar surgical outcomes, the 5-year cancer-specific survival rate of patients with stage IV EOCRC was significantly lower than that of patients with LOCRC (32.8 % vs. 51.9 %, p = 0.012).

Conclusion

This study highlights a persistent rise in the incidence of EOCRC, with patients presenting with more aggressive disease and experiencing inferior survival. These findings underscore the importance of heightened awareness and early detection strategies for CRC, especially in younger populations, to improve the prognosis.

导言结直肠癌（CRC）是全球重大的健康负担，其中早发结直肠癌（EOCRC）病例显著增加，早发结直肠癌是指在50岁之前确诊的病例。材料与方法本研究利用台湾国家癌症登记处的数据和长庚纪念医院的回顾性队列，分析了2008年至2019年间确诊的CRC病例。分析结果显示，EOCRC 的年发病率持续上升，结肠癌和直肠癌的发病率分别上升了 3.2% 和 3.3%。EOCRC 患者的疾病特征更具侵袭性，如标志环细胞腺癌、粘液腺癌和分化程度差。与 LOCRC（50.3%）相比，EOCRC（62.4%）患者诊断时的晚期（III 期和 IV 期）更为常见。与 LOCRC 组相比，EOCRC 患者更常报告直肠出血、排便习惯改变和腹痛。大便相关症状与左侧结肠癌之间存在密切联系。尽管手术结果相似，但 IV 期 EOCRC 患者的 5 年癌症特异性生存率明显低于 LOCRC 患者（32.8% 对 51.9%，P = 0.012）。这些发现强调了提高对 CRC 的认识和早期检测策略的重要性，尤其是在年轻人群中，以改善预后。

{"title":"Differences in characteristics and outcomes between early-onset colorectal cancer and late-onset colorectal cancers","authors":"","doi":"10.1016/j.ejso.2024.108687","DOIUrl":"10.1016/j.ejso.2024.108687","url":null,"abstract":"<div><h3>Introduction</h3><p>Colorectal cancer (CRC) represents a significant health burden worldwide, with a notable increase in early-onset colorectal cancer (EOCRC) cases, defined as those diagnosed before the age of 50 years.</p></div><div><h3>Materials and methods</h3><p>Using data from Taiwan's national cancer registry and a retrospective cohort from Chang Gung Memorial Hospital, this study analyzed CRC cases diagnosed between 2008 and 2019. The analysis compared the EOCRC and late-onset CRC (LOCRC) groups in terms of clinicopathological characteristics, pre-diagnostic symptoms, and survival outcomes.</p></div><div><h3>Results</h3><p>The analysis revealed a continuous increase in the annual incidence of EOCRC, with colon cancer and rectal cancer rising by 3.2 % and 3.3 %, respectively. Patients with EOCRC presented with more aggressive disease characteristics, such as signet-ring cell adenocarcinoma, mucinous adenocarcinoma, and poorly differentiated grade. Advanced stages at diagnosis, stages III and IV, were more common with EOCRC (62.4 %) than with LOCRC (50.3 %). Patients with EOCRC reported rectal bleeding, changes in bowel habits, and abdominal pain more frequently than those in the LOCRC group. There is a strong association between stool-related symptoms and left-sided CRC. Despite similar surgical outcomes, the 5-year cancer-specific survival rate of patients with stage IV EOCRC was significantly lower than that of patients with LOCRC (32.8 % vs. 51.9 %, p = 0.012).</p></div><div><h3>Conclusion</h3><p>This study highlights a persistent rise in the incidence of EOCRC, with patients presenting with more aggressive disease and experiencing inferior survival. These findings underscore the importance of heightened awareness and early detection strategies for CRC, especially in younger populations, to improve the prognosis.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S074879832400739X/pdfft?md5=8375ed1bf842aad6160d8fa4874f6d0d&pid=1-s2.0-S074879832400739X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Progress of intracranial metastases during the interval before stereotactic radiosurgery, a retrospective cohort analysis 立体定向放射外科手术前颅内转移灶进展情况的回顾性队列分析

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-10 DOI: 10.1016/j.ejso.2024.108676

Introduction

The incidence of intracranial metastatic disease is increasing worldwide. As a valuable treatment modality, stereotactic radiosurgery requires detailed imaging, and this study evaluated the differences between imaging obtained on the day of treatment compared to historical or referral imaging.

Materials and methods

A retrospective cohort study was performed, evaluating all the patients presenting with eligible referral imaging in a 13-month period and comparing this imaging to the imaging taken on the day of treatment. Numbers of additional metastases, volumes and volume differences among the images were compared.

Results

There was a median interval of 19 days between the acquisition of the diagnostic or referral scan and the day of treatment imaging. Even the group that had the shortest interval (up to 2 weeks) showed at least one additional deposit in 50 % of the patients. Volume was increased in 75 % of this group. Longer intervals were associated with higher increases in volume.

Conclusion

These results demonstrate the increase in the disease burden in patients with intracranial metastatic disease, in relation to number and volume, in the interval between the referral and treatment imaging. This has significant implications for planning pathways, to ensure that metastatic deposits are not missed or undertreated.

导言颅内转移性疾病的发病率在全球呈上升趋势。作为一种重要的治疗方式，立体定向放射外科需要详细的成像，本研究评估了治疗当天获得的成像与历史或转诊成像之间的差异。材料和方法进行了一项回顾性队列研究，评估了 13 个月内所有符合转诊成像条件的患者，并将这些成像与治疗当天的成像进行了比较。结果诊断或转诊扫描与治疗当天的成像之间的中位间隔为 19 天。即使是间隔时间最短的一组（最长 2 周），也有 50% 的患者至少多出一个沉积物。在这组患者中，75%的患者血容量增加。这些结果表明，颅内转移性疾病患者的疾病负担在转诊和治疗成像之间的间隔期内，在数量和体积上都有所增加。这对规划治疗路径具有重要意义，可确保转移性沉积物不会被漏诊或治疗不足。

{"title":"Progress of intracranial metastases during the interval before stereotactic radiosurgery, a retrospective cohort analysis","authors":"","doi":"10.1016/j.ejso.2024.108676","DOIUrl":"10.1016/j.ejso.2024.108676","url":null,"abstract":"<div><h3>Introduction</h3><p>The incidence of intracranial metastatic disease is increasing worldwide. As a valuable treatment modality, stereotactic radiosurgery requires detailed imaging, and this study evaluated the differences between imaging obtained on the day of treatment compared to historical or referral imaging.</p></div><div><h3>Materials and methods</h3><p>A retrospective cohort study was performed, evaluating all the patients presenting with eligible referral imaging in a 13-month period and comparing this imaging to the imaging taken on the day of treatment. Numbers of additional metastases, volumes and volume differences among the images were compared.</p></div><div><h3>Results</h3><p>There was a median interval of 19 days between the acquisition of the diagnostic or referral scan and the day of treatment imaging. Even the group that had the shortest interval (up to 2 weeks) showed at least one additional deposit in 50 % of the patients. Volume was increased in 75 % of this group. Longer intervals were associated with higher increases in volume.</p></div><div><h3>Conclusion</h3><p>These results demonstrate the increase in the disease burden in patients with intracranial metastatic disease, in relation to number and volume, in the interval between the referral and treatment imaging. This has significant implications for planning pathways, to ensure that metastatic deposits are not missed or undertreated.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reply to: Vaginal surgery for cervical cancer based on the recent results of LACC, SHAPE, SUCCOR and ConCerv trials. 回复：基于 LACC、SHAPE、SUCCOR 和 ConCerv 试验最新结果的宫颈癌阴道手术。

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-09-07 DOI: 10.1016/j.ejso.2024.108656

Limor Helpman, Laurence Bernard, Gregory Pond

引用次数: 0