MDT在1例巨大腹膜后小细胞癌诊治中的应用

Application of MDT in the diagnosis and treatment of a huge retroperitoneal small cell carcinoma

目的总结MDT模式在1例巨大腹膜后小细胞癌诊疗过程中的应用效果。方法回顾性分析笔者所在医院于2018年4月诊治的1例腹膜后小细胞癌患者的临床资料。根据病情对该患者采用MDT机制进行影像科、肿瘤内科、血管外科、泌尿外科及麻醉科专家的多学科会诊讨论。结果 MDT讨论结果:患者一般情况良好,目前腹膜后巨大占位性病变诊断明确,肿瘤与周围器官关系密切,但在多个学科协作下可根治性切除,决定行手术治疗,且成功行R0切除。手术历时365 min,术中出血约200 mL,术后病理回报切缘阴性。术后无明显手术并发症,总住院时间为23 d。出院后4个月患者于笔者所在医院复查提示肿瘤复发,行放化疗联合治疗,治疗中患者病情平稳。结论对于涉及多个学科的罕见腹膜后小细胞癌病例,以MDT模式为基础的治疗方案更安全可行,可为患者带来更好的临床结局。

Objective To explore the application of MDT mode in the diagnosis and treatment of a large retroperitoneal small cell carcinoma.Methods A huge retroperitoneal tumor about 25 cm×18 cm was found by the preoperative abdominal MRI examination,which was considered as the malignant tumor.Considering the patient’s condition,MDT consultation of the specialists in radiology,oncology,vascular surgery,urinary surgery,and anesthesiology was conducted.Results By MDT discussion,the general condition of patient was good.At present,the diagnosis of the huge retroperitoneal tumor was confirmed.Although the tumor was surrounded with related organs closely,yet the radical operation was finished smoothly and the R0 resection was achieved through the collaboration of MDT.The operation lasted 365 minutes,and the intraoperative blood loss was about 200 mL.Postoperative pathology confirmed that the tumor margin was negative and no postoperative complication occurred.The total number of hospital stays was 23 days.The patient’s return to the hospital for review in 4 months after discharge revealed a tumor recurrence.Then,combined with radiotherapy and chemotherapy,the patient’s condition was stable during treatment.Conclusion For rare cases of retroperitoneal small cell carcinoma involving multiple disciplines,the treatment based on MDT is able to bring better clinical outcome to patients due to safer and more feasible.