Early invasive cancer in adenomatous colonic polyps ("malignant polyps"). Evaluation of the therapeutic options by decision analysis.
Early invasive cancer in adenomatous colonic polyps ("malignant polyps"). Evaluation of the therapeutic options by decision analysis.
复制标题
腺瘤性结肠息肉（“恶性息肉”）中的早期浸润性癌症。
DOI：
10.1016/s0016-5085(87)91072-9
复制
发表时间：
1987
期刊：
影响因子：
29.4
通讯作者：
Beck,JR
中科院分区：
文献类型：
--
作者：
Wilcox,GM;Beck,JR
采用决策树分析方法对早期浸润性癌结肠腺瘤(即息肉切除无肿瘤切缘)的治疗方案进行评价。使用文献中的数据，影响决定的主要变量如下：(A)息肉切除术后残留疾病的概率，(B)手术疗效(定义为治愈不手术即可复发的肿瘤的机会)，以及(C)手术死亡率。对于手术风险较低的假想患者(手术死亡率为0.2%)，只要残留疾病的概率为0.5%，就预期寿命而言，切除手术将产生最好的结果。对描述这一问题的参数假设的变化的影响进行了广泛的分析，表明这一结论在手术疗效和残留病概率的广泛范围内是不变的。然而，在这种情况下进行二次切除的决定仍然很接近，因为手术在经济上只是微不足道的。对于手术风险较高(手术死亡率为2%)的患者，应优先进行观察。
The management alternatives of segmental colonic resection versus follow-up alone for colonic adenomas containing early invasive carcinoma (i.e., polypectomy resection margin free of tumor) were evaluated by decision tree analysis. Using data from the literature, the major variables influencing the decision were as follows: (a) probability of residual disease after polypectomy, (b) operative efficacy (defined as the chance of curing a tumor that would otherwise recur without surgery), and (c) operative mortality. For a hypothetical patient with low operative risk (operative mortality of 0.2%), resection would yield the best outcome in terms of life expectancy as long as the probability of residual disease was >0.5%. Extensive analysis of the impact of changes in assumptions about the parameters characterizing the problem showed this conclusion to be unchanging over wide ranges of operative efficacy and probability of residual disease. However, the decision to do a secondary resection in this situation was still close because surgery ~as only marginally justifiable on economic grounds. Observation would be preferred in patients with higher operative risk (operative mortality >2%).
登录
查看更多内容
影响因子：
158.5
作者：
MCNEIL, BJ;KEELER, E;ADELSTEIN, SJ
通讯作者：
ADELSTEIN, SJ
通过个人计算机进行临床决策分析。
影响因子：
--
作者：
S. Pauker;J. Kassirer
通讯作者：
J. Kassirer
结肠镜息肉切除术切除含有恶性肿瘤的息肉患者的治疗
影响因子：
3.9
作者：
J. Langer;Z. Cohen;B. Taylor;S. Stafford;K. Jeejeebhoy;J. Cullen
通讯作者：
J. Cullen
“恶性”结肠息肉的根治性治疗
影响因子：
9
作者：
W. Wolff;H. Shinya
通讯作者：
H. Shinya
早期结直肠癌局部切除的政策。
影响因子：
24.5
作者：
B. Morson;H. Bussey;S. Samoorian
通讯作者：
S. Samoorian