优化复发性子宫内膜癌二次细胞切除手术的患者选择。

IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Virginia Vargiu, Andrea Rosati, Lucia Tortorella, Diana Giannarelli, Vito Andrea Capozzi, Valerio Gallotta, Alessandro Gioè, Ettore Di Stefano, Martina Corrado, Roberto Berretta, Francesco Cosentino, Giovanni Scambia, Francesco Fanfani
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引用次数: 0

摘要

研究目的这项多中心回顾性观察研究旨在完善复发性子宫内膜癌二次细胞减灭术的患者选择标准。目的是确定完全细胞减灭术的术前预测因素,评估手术复杂性,并提出一套术前预测评分系统,以确定二次细胞减灭术的合适人选:方法: 分析了2010年1月至2021年12月期间意大利三个中心的331名复发性子宫内膜癌妇女的数据。根据患者接受的治疗(药物治疗、诊断性腹腔镜检查/麻醉下检查或二次细胞减灭术)进行分类。对术前预测因素、手术复杂程度、并发症和预测评分系统进行了评估。统计评估采用了逻辑回归和接受者操作特征分析:队列中,56.2%的患者接受了剥离手术,17.2%的患者接受了腹腔镜诊断,26.6%的患者接受了药物治疗。接受二次细胞减灭术的患者年龄较轻,体重指数较低,表现较好,合并症较少。二次细胞减灭术患者中,单部位局部复发很常见。年龄 结论:本研究确定了年龄
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimizing patient selection for secondary cytoreductive surgery in recurrent endometrial cancer.

Objective: This retrospective, multicenter, observational study aimed to refine patient selection criteria for secondary cytoreductive surgery in recurrent endometrial cancer. The objective was to identify preoperative predictors of complete cytoreduction, assess surgical complexity, and propose a preoperative predictive scoring system to identify suitable candidates for secondary cytoreductive surgery.

Methods: Data from 331 women with recurrent endometrial cancer were analyzed across three Italian centers from January 2010 to December 2021. Patients were categorized based on treatment received (medical treatment, diagnostic laparoscopy/examination under anesthesia, or secondary cytoreductive surgery). Preoperative predictors, surgical complexity, complications, and a predictive scoring system were assessed. Logistic regression and receiver operating characteristic analysis were used for statistical evaluation.

Results: Of the cohort, 56.2% underwent debulking surgery, 17.2% had diagnostic laparoscopy, and 26.6% received medical treatment. Patients undergoing secondary cytoreductive surgery were younger, with a lower body mass index, better performance status, and fewer comorbidities. Single site locoregional relapse was common in secondary cytoreductive surgery patients. Age <65 years, single site relapse, lymph node, and hematogenous relapse were independent predictors of complete cytoreduction. A predictive scoring system demonstrated a clear relationship between the score and the likelihood of complete cytoreduction.

Conclusion: This study identified age <65 years, single site recurrence, as well as nodal and hematogenous recurrence, as predictive factors for achieving optimal cytoreduction. A predictive scoring system incorporating these factors has been proposed to identify optimal candidates for secondary cytoreductive surgery in recurrent endometrial cancer. The scoring system showed promising predictive accuracy and could aid in refining the decision making process, ensuring appropriate patient selection for secondary cytoreductive surgery. Further prospective studies are warranted to validate and enhance the predictive model.

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来源期刊
CiteScore
6.60
自引率
10.40%
发文量
280
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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