The present study sought to identify the therapeutic efficacy of adjuvant external beam radiotherapy (EBRT) for carcinomas of the extrahepatic bile duct (EHBD) and gallbladder. Twenty-one patients with pathologically ...The present study sought to identify the therapeutic efficacy of adjuvant external beam radiotherapy (EBRT) for carcinomas of the extrahepatic bile duct (EHBD) and gallbladder. Twenty-one patients with pathologically verified EHBD carcinoma and 18 patients with gallbladder carcinoma were analyzed retrospectively by Cox regression analysis for predictors of survival. The overall 5-year survival rates after resection were 33%for EHBD carcinoma and 56%for gallbladder carci noma. The overall 5-year survival rate for EHBD carcinoma was 60%in 8 patients without microscopic residual disease (RO), 15%in 9 patients with microscopic r esidual tumor (R1), and 0%in 4 patients with macroscopic residual tumor (R2). T he overall 5-year survival rate of gallbladder carcinoma patients was also decr eased with R status equal to 73%, 40%, and 0%for RO, R1 and R2, respectively. Adjuvant radiotherapy significantly improved the 5-year survival rate in 7 pat ients with R1 disease of EHBD carcinoma (P = .035), compared with survival in 2 patients who underwent resection alone. However, no significant difference was n oted in the 5-year survival rate between the resection plus EBRT group and the resection alone group for gallbladder carcinoma. Multivariate analysis revealed that histopathologic grade (G) was an independent predictor of survival for EHBD carcinoma and that direct invasion of liver parenchyma was a predictor of survi val for gallbladder carcinoma. This study suggests that curative resection provi des the best survival for patients with EHBD and gallbladder carcinoma, and that radiotherapy may play a beneficial role in controlling local-regional residual EHBD carcinoma tumors. However, new strategies for adjuvant therapy are needed to improve survival in patients with gallbladder carcinoma.展开更多
目的探讨三孔法经腹膜外腹腔镜下根治性前列腺切除术(ELRP)治疗局限性前列腺癌的效果。方法回顾性分析新乡医学院第三附属医院泌尿外科2018-01—2019-06行ELRP治疗的93例局限性前列腺癌患者的临床资料。采用三孔法ELRP治疗的(49例)为观...目的探讨三孔法经腹膜外腹腔镜下根治性前列腺切除术(ELRP)治疗局限性前列腺癌的效果。方法回顾性分析新乡医学院第三附属医院泌尿外科2018-01—2019-06行ELRP治疗的93例局限性前列腺癌患者的临床资料。采用三孔法ELRP治疗的(49例)为观察组,采用四孔法ELRP治疗的44例为对照组。对比2组围术期指标、术前、术后1 d、术后3 d血清应激反应指标肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)、血糖(Glu),胰岛素样生长因子1(IGF-1),游离前列腺特异性抗原(fPSA)水平及术后12个月尿失禁发生率、生化复发率。结果观察组手术时间短于对照组,术中出血量低于对照组,差异有统计学意义(P<0.05);2组术后Gleason评分、术后尿管留置时间、住院时间差异无统计学意义(P>0.05);术后1 d、术后3 d 2组血清E、NE、Cor、Glu水平高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后1 d、术后3 d 2组血清fPSA、IGF-1水平低于术前,差异有统计学意义(P<0.05),2组间对比差异无统计学意义(P>0.05);2组术后12个月尿失禁发生率、生化复发率比较,差异无统计学意义(P>0.05)。结论三孔法、四孔法ELRP治疗局限性前列腺癌患者效果相当,但三孔法具有创伤小、手术时间短、出血少、应激反应轻等优势。展开更多
文摘The present study sought to identify the therapeutic efficacy of adjuvant external beam radiotherapy (EBRT) for carcinomas of the extrahepatic bile duct (EHBD) and gallbladder. Twenty-one patients with pathologically verified EHBD carcinoma and 18 patients with gallbladder carcinoma were analyzed retrospectively by Cox regression analysis for predictors of survival. The overall 5-year survival rates after resection were 33%for EHBD carcinoma and 56%for gallbladder carci noma. The overall 5-year survival rate for EHBD carcinoma was 60%in 8 patients without microscopic residual disease (RO), 15%in 9 patients with microscopic r esidual tumor (R1), and 0%in 4 patients with macroscopic residual tumor (R2). T he overall 5-year survival rate of gallbladder carcinoma patients was also decr eased with R status equal to 73%, 40%, and 0%for RO, R1 and R2, respectively. Adjuvant radiotherapy significantly improved the 5-year survival rate in 7 pat ients with R1 disease of EHBD carcinoma (P = .035), compared with survival in 2 patients who underwent resection alone. However, no significant difference was n oted in the 5-year survival rate between the resection plus EBRT group and the resection alone group for gallbladder carcinoma. Multivariate analysis revealed that histopathologic grade (G) was an independent predictor of survival for EHBD carcinoma and that direct invasion of liver parenchyma was a predictor of survi val for gallbladder carcinoma. This study suggests that curative resection provi des the best survival for patients with EHBD and gallbladder carcinoma, and that radiotherapy may play a beneficial role in controlling local-regional residual EHBD carcinoma tumors. However, new strategies for adjuvant therapy are needed to improve survival in patients with gallbladder carcinoma.
文摘目的探讨三孔法经腹膜外腹腔镜下根治性前列腺切除术(ELRP)治疗局限性前列腺癌的效果。方法回顾性分析新乡医学院第三附属医院泌尿外科2018-01—2019-06行ELRP治疗的93例局限性前列腺癌患者的临床资料。采用三孔法ELRP治疗的(49例)为观察组,采用四孔法ELRP治疗的44例为对照组。对比2组围术期指标、术前、术后1 d、术后3 d血清应激反应指标肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)、血糖(Glu),胰岛素样生长因子1(IGF-1),游离前列腺特异性抗原(fPSA)水平及术后12个月尿失禁发生率、生化复发率。结果观察组手术时间短于对照组,术中出血量低于对照组,差异有统计学意义(P<0.05);2组术后Gleason评分、术后尿管留置时间、住院时间差异无统计学意义(P>0.05);术后1 d、术后3 d 2组血清E、NE、Cor、Glu水平高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后1 d、术后3 d 2组血清fPSA、IGF-1水平低于术前,差异有统计学意义(P<0.05),2组间对比差异无统计学意义(P>0.05);2组术后12个月尿失禁发生率、生化复发率比较,差异无统计学意义(P>0.05)。结论三孔法、四孔法ELRP治疗局限性前列腺癌患者效果相当,但三孔法具有创伤小、手术时间短、出血少、应激反应轻等优势。
