肿瘤治疗前进行代谢和减肥手术的可行性和结果

IF 3.5 3区 医学 Q1 SURGERY Surgery for Obesity and Related Diseases Pub Date : 2024-08-01 DOI:10.1016/j.soard.2024.02.008
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引用次数: 0

摘要

背景代谢与减肥手术(MBS)是一种有效的干预措施,可解决与肥胖相关的医疗问题并实现可持续的减肥效果。除常规作用外,代谢与减肥手术还被证明有可能成为需要各种干预措施的患者的过渡步骤。目的探讨MBS作为降低良性肿瘤或低级别癌症患者手术和治疗风险的一种可能尝试的可行性。方法对诊断为原发性肿瘤、因肥胖而被视为无法手术或高风险、并在肿瘤治疗前接受初级MBS的患者进行回顾性研究。数据包括基线特征、肿瘤特征、MBS结果和肿瘤治疗结果。结果共纳入37名患者(中位年龄52岁,75.7%为女性,中位体重指数为49.1 kg/m2)。原发性肿瘤有9个不同的起源器官,其中子宫内膜(43.2%)最常见,其次是胰腺、结肠、肾脏和乳腺。袖带胃切除术(SG)是最常见的 MBS 手术(78.4%),在平均 4.3 ± 3.9 年的时间里,没有与 MBS 相关的并发症或死亡病例报告。31名患者(83.8%)最终接受了肿瘤手术,平均体重指数(BMI)从手术时的49.9 kg/m2下降到39.7 kg/m2,平均下降时间为5.8 ± 4.8个月。结论这项研究强调了在肥胖的情况下,对低级别、侵袭性较低的肿瘤患者在肿瘤治疗前使用 MBS 的潜在可行性。这凸显了为这些患者提供个性化、因人而异的多学科治疗方法的重要性。
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The feasibility and outcomes of metabolic and bariatric surgery prior to neoplastic therapy

Background

Metabolic and bariatric surgery (MBS) is a potent intervention for addressing obesity-related medical conditions and achieving sustainable weight loss. Beyond its conventional role, MBS has demonstrated potential to serve as a transitional step for patients requiring various interventions. However, the implications of MBS in the context of neoplasia remain understudied.

Objectives

To explore the feasibility of MBS as a possible attempt to reduce surgical and treatment risks in patients with benign tumors or low-grade cancers.

Setting

Multicenter review from twelve tertiary referral centers spanning 8 countries.

Methods

A retrospective review of patients with a diagnosis of primary neoplasia, deemed inoperable or high-risk due to obesity, and receiving primary MBS prior to neoplastic therapy. Data encompassed baseline characteristics, neoplasia characteristics, MBS outcomes, and neoplastic therapy outcomes.

Results

Thirty-seven patients (median age 52 years, 75.7% female, median BMI of 49.1 kg/m2) were included. There were 9 distinct organs of origin of primary neoplasia, with the endometrium (43.2%) being the most common, followed by the pancreas, colon, kidney and breast. Sleeve gastrectomy (SG) was the most commonly performed MBS procedure (78.4%), with no MBS-related complications or mortalities reported over an average of 4.3 ± 3.9 years. Thirty-one patients (83.8%) eventually underwent neoplastic surgery, with a mean BMI decrease from 49.9 kg/m2 to 39.7 kg/m2 at surgery over an average of 5.8 ± 4.8 months. There were 2 (6.7%) documented mortalities associated with neoplastic surgical intervention.

Conclusions

This study highlights the potential feasibility of employing MBS prior to neoplastic therapy in patients with low-grade, less aggressive neoplasms in the context of obesity. This underscores the importance of providing a personalized, case-to-case multidisciplinary approach in the management of these patients.

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来源期刊
CiteScore
6.70
自引率
12.90%
发文量
570
审稿时长
56 days
期刊介绍: Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Brazilian Society for Bariatric Surgery, is an international journal devoted to the publication of peer-reviewed manuscripts of the highest quality with objective data regarding techniques for the treatment of severe obesity. Articles document the effects of surgically induced weight loss on obesity physiological, psychiatric and social co-morbidities.
期刊最新文献
Editorial Board Table of Contents SOARD Category 1 CME Credit Featured Articles, Volume 20, November 2024 Cartoon Editorial Board
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