检测项目第一部分：前纵隔囊性病变诊断与治疗的国际德尔菲调查。

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2025-01-01 DOI:10.1016/j.lungcan.2024.108055

Florit Marcuse , Daphne Dumoulin , Koen Hartemink , Monique Hochstenbag , Sjaak Burgers , Hester A. Gietema , Ties A. Mulders , Elvin Eryigit , Jos Maessen , Lex Maat , Myrurgia Abdul Hamid , Jan von der Thüsen , Kim Monkhorst , Anne-Marie C. Dingemans , Nicolas Girard

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引用次数: 0

摘要

背景：在临床实践中鉴别良性前纵隔囊肿与恶性囊肿具有挑战性。关于前纵隔囊性病变的最佳诊断和治疗的国际指南缺乏。探测项目的第一部分侧重于国际胸科医学专家在前纵隔囊性病变的诊断和治疗方面可能存在的异质性。方法：delphi调查是由14名多学科小组成员创建的，隶属于三家荷兰三级胸腺肿瘤转诊医院。该调查包含55个问题，并由国际胸腺恶性肿瘤兴趣小组（ITMIG）和英国胸腺肿瘤与癌症协会（RYTHMIC）的国际专家进行了审查。该调查于2023年5月26日至2023年7月18日在网上对ITMIG和RYTHMIC的成员发起。结果：来自24个国家的21名胸外科医生、15名放射科医生、15名内科肿瘤科医生、11名病理学家、9名肺科医生和4名放射肿瘤科医生完成了调查。前纵隔囊肿的影像学诊断、实验室检查、手术指征和随访均存在异质性。胸外科医生（76.2%）比肺科医生（44.4%）和内科肿瘤科医生（15.4%）更常将前纵隔囊肿囊壁厚度作为临床决策的相关因素（p = 0.015）。结论：调查结果显示胸科医学专家对前纵隔囊肿的诊断和切除指征存在差异。我们观察到前纵隔囊肿在影像学、实验室检查、手术、病理分析和随访方面存在很大差异。循证临床实践指南的制定可以指导临床医生。

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The DETECTION project part 1: An international Delphi survey about diagnostics and treatment of anterior mediastinal cystic lesions

Background

Differentiating benign anterior mediastinal cysts from malignancies is challenging in clinical practice. International guidelines on optimal diagnostics and treatment for anterior mediastinal cystic lesions are lacking. The first part of the DETECTION project focuses on possible heterogeneity in diagnostics and treatment of anterior mediastinal cystic lesions among international thoracic medical experts.

Methods

A Delphi-survey was created by 14 multidisciplinary panel members, affiliated with three Dutch tertiary referral hospitals for thymic tumours. The survey contained 55 questions and was reviewed by international experts of the International Thymic Malignancy Interest Group (ITMIG) and Réseau tumeurs THYMiques et Cancer (RYTHMIC). The survey was launched online for members of the ITMIG and RYTHMIC from May 26th, 2023 till July 18th, 2023.

Results

The survey was completed by 21 thoracic surgeons, 15 radiologists, 15 medical oncologists, 11 pathologists, 9 pulmonologists, and 4 radiation oncologists from 24 countries. Heterogeneity was observed in performed diagnostic radiological imaging, laboratory tests, indications for surgery and follow-up of anterior mediastinal cysts. Cystic wall thickness of anterior mediastinal cysts was reported as clinical relevant in decision making more frequently by thoracic surgeons (76.2 %) than pulmonologists (44.4 %) and medical oncologists (15.4 %) (p = 0.015).

Conclusions

The survey outcomes showed heterogeneity in the diagnostics and indication for resection of anterior mediastinal cysts among thoracic medical experts. A large variation in radiological imaging, laboratory tests, surgery, pathological analyses, and follow-up of anterior mediastinal cysts was observed. The development of evidence-based clinical practice guidelines may guide clinicians.

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.