Excisional surgery for cancer cure: therapy at a cost
Excisional surgery for cancer cure: therapy at a cost
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DOI：
10.1016/s1470-2045(03)01282-8
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发表时间：
2003-12-01
期刊：
影响因子：
51.1
通讯作者：
Redmond, HP
中科院分区：
文献类型：
--
作者：
Coffey, JC;Wang, JH;Redmond, HP
切除手术是癌症的主要治疗方式之一。微小残留病（MRD）是治疗性手术后仍留在原位的隐匿性肿瘤疾病。越来越多的证据表明，肿瘤切除改变了MRD的生长，导致围手术期肿瘤生长。由于肿瘤是一种全身性疾病，这种现象可能与所有接受癌症手术的患者有关。在这篇综述中，我们讨论了已发表的工作，解决肿瘤切除对随后的肿瘤生长的影响和肿瘤切除可能会改变残余肿瘤生长的机制。此外，我们描述了治疗方法，可以保护患者免受肿瘤切除的任何肿瘤学不良反应。在现有证据的基础上，我们提出了一种新的治疗模式，即术后时期代表了一个机会之窗，在此期间，患者可以进一步免受肿瘤切除的肿瘤学影响。
Excisional surgery is one of the primary treatment modalities for cancer. Minimal residual disease (MRD) is the occult neoplastic disease that remains in situ after curative surgery. There is increasing evidence that tumour removal alters the growth of MRD, leading to perioperative tumour growth. Because neoplasia is a systemic disease, this phenomenon may be relevant to all patients undergoing surgery for cancer. In this review we discuss the published work that addresses the effects of tumour removal on subsequent tumour growth and the mechanisms by which tumour excision may alter residual tumour growth. In addition, we describe therapeutic approaches that may protect patients against any oncologically adverse effects of tumour removal. On the basis of the evidence presented, we propose a novel therapeutic paradigm; that the postoperative period represents a window of opportunity during which the patient may be further protected against the oncological effects of tumour removal.