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转移病灶治疗方案

发布者:鑫达医学翻译 发布时间:2013-07-31 8:50:52 阅读:

原文:

Most patients with metastatic disease ultimately relapse. This author has some anecdotal cases of patients with initial node positive disease who responded well to chemotherapy and had surgical consolidation with a partial or complete cystectomy with en-bloc resection of the urachal ligament with umbilicus and lymph node dissection. Some of these patients still remain cancerfree at more than 4 years of follow-up. However, additional long-term follow-up data are required to determine whether these patients have been cured of their malignancy. Given the slow progression rates sometimes observed with these patients, there also may be arole for resection of low-volume metastatic sites, including lung.

While it is difficult to ascertain the effect of metastatectomy in altering the natural course of their disease, we currently consider this following the usual oncologic principals of resecting slowly growing metastases in a surgically resectable solitary organ site after control with systemic chemotherapy. Resection of rapidly growing disease, or disease involving multiple visceral sites, including peritoneal carcinomatosis, is not recommended.

译文:

肿瘤一旦发生转移,就容易导致复发。该作者还提到有些发生淋巴转移患者对化疗产生应答。并且,这些患者进行手术巩固,如膀胱部分切除或完全切除(连同脐尿管韧带)、脐切除或淋巴结切除。其中有些患者,随访4年期间尚未发现出现癌症。但仍需长期随访资料,以证实这些患者确实被治愈。鉴于有些患者疾病进展缓慢,切除术对转移率较慢的病灶(如肺部)有一定的作用。

当前,很难断定转移灶切除对疾病自然进展的影响。我们倾向于支持系统性化疗后,如为独立病灶、且缓慢转移,可以考虑切除手术。但对快速转移的病种,或转移至多处内脏器官的病种(含腹膜扩散),不建议采用切除术。

 

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