Intestinal type adenocarcinoma of the ethmoid: Outcomes of a treatment regimen based on endoscopic surgery with or without radiotherapy
Intestinal type adenocarcinoma of the ethmoid: Outcomes of a treatment regimen based on endoscopic surgery with or without radiotherapy
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DOI：
10.1002/hed.24144
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发表时间：
2016-04-01
影响因子：
2.9
通讯作者：
Castelnuovo, Paolo
中科院分区：
文献类型：
--
作者：
Nicolai, Piero;Schreiber, Alberto;Castelnuovo, Paolo
背景。本研究的目的是评估一组接受经鼻内窥镜手术+/-放疗 (RT) 治疗的肠型腺癌 (ITAC) 患者的生存率、预后因素和并发症。方法。对在 2 个三级中心接受内窥镜手术 +/- RT 的 ITAC 患者进行回顾性评价。计算总生存期 (OS) 和无事件生存期，并将具有统计学意义的变量输入多元 Cox 回归模型。还分析了并发症。结果。其中包括一百六十九名患者。 9.5%的患者出现主要并发症。 58.6% 的患者接受了辅助放疗。五年 OS 和无事件生存率分别为 68.9% 和 63.6%。高级 pT 分类、高级别和阳性手术切缘是生存率较差的独立预测因素。结论。在大多数 ITAC 病例中，内窥镜手术 +/- RT 是有效的治疗选择。与基于外部手术的系列相比，我们的结果支持 ITAC 管理的明确范式转变。 (c) 2015 年 Wiley 期刊公司。
Background. The purpose of this study was to assess survival, prognostic factors, and complications in a cohort of patients with intestinal-type adenocarcinoma (ITAC) treated with transnasal endoscopic surgery +/- radiotherapy (RT).Methods. Patients with ITAC who underwent endoscopic surgery +/- RT at 2 tertiary centers were retrospectively reviewed. Overall survival (OS) and event-free survival were calculated, and statistically significant variables were entered in a multivariate Cox regression model. Complications were also analyzed.Results. One hundred-sixty-nine patients were included. Major complications occurred in 9.5% of patients. Adjuvant RT was delivered in 58.6% of patients. Five-year OS and event-free survival were 68.9% and 63.6%, respectively. Advanced pT classification, high-grade, and positive surgical margins were independently predictive of poor survival.Conclusion. Endoscopic surgery +/- RT is a valid treatment option in most cases of ITAC. When compared with series based on external surgery, our results support a definitive paradigm shift in the management of ITAC. (c) 2015 Wiley Periodicals, Inc.