Qian Bo,Mo Xuming,Qi Jirong,et al.Surgical strategies for advanced malignant chest tumors in children[J].Journal of Clinical Pediatric Surgery,2025,(05):419-423.[doi:10.3760/cma.j.cn101785-202501066-005]
小儿胸部实体进展期恶性肿瘤手术策略的临床研究
- Title:
- Surgical strategies for advanced malignant chest tumors in children
- Keywords:
- Tumor; Thorax; Neuroblastoma; Lymphoma; Wilms Tumor; Ewing Sarcoma; Surgical Procedures; Operative; Response Evaluation Criteria in Solid Tumors; Child
- 摘要:
- 目的 探讨小儿胸部恶性实体肿瘤化疗后再手术的临床特征及预后相关因素。方法 回顾性分析2017年1月至2024年11月南京医科大学附属儿童医院收治的44例儿童胸部实体恶性肿瘤经化疗后再手术患儿临床资料,男28例、女16例;年龄(70±51.8)个月;初诊肿瘤长径(9.2±4.15)cm;初诊为4期34例,3期10例。采用Kaplan-Meier分析计算患儿5年生存时间(overall Survival,OS)和无事件生存期(event-free survival,EFS)。结果 44例患儿中,34例经历1次手术,8例经历2次手术,1例经历3次手术,1例经历6次手术。经综合治疗后,总生存率86.36%(38/44),其中神经母细胞瘤总生存率100.00%(14/14),淋巴瘤治愈率80.00%(4/5),生殖源性肿瘤治愈率80.00%(4/5),肾母细胞瘤总生存率75.00%(6/8),尤文肉瘤总生存率60.00%(3/5)。Kaplan-Meier分析提示,肿瘤分期和初诊肿瘤长径与肿瘤患儿无事件生存时间显著相关(P＜0.05)。结论 以手术为主的多学科联合治疗可显著延长小儿胸部进展期恶性实体肿瘤的生存时间。
- Abstract:
- Objective To explore the clinical characteristics and prognostic factors of reoperation after chemotherapy for advanced solid malignant chest tumor in children. Methods From January 2017 to November 2024,the relevant clinical data were retrospectively reviewed for 44 children of solid malignant chest tumor reoperated after chemotherapy.There were 28 boys and 16 girls with an average age of (70±51.8) month and average diameter of tumor (9.2±4.15) cm.At the time of initial diagnosis,there were stage Ⅳ distant metastasis (n=34) and stage Ⅲ local metastasis (n=10).Kaplan-Meier analysis was utilized for calculating the values of overall survival (OS) and event-free survival (EFS). Results Among them,operative frequency was 2 (n=8),3 (n=1) and 6 (n=1).After comprehensive treatment,OS rate reached 86.36%(38/44),including 100.00%(14/14) for neuroblastoma,80.00%(4/5) for lymphoma,80.00%(4/5) for genital tumor and 75.00%(4/5) for nephroblastoma.Kaplan-Meier analysis revealed that tumor stage and newly diagnosed tumor diameter were significantly correlated with EFS. Conclusions Multidisciplinary comprehensive management,dominated by surgery,can significantly improve the survival profiles of solid advanced malignant chest tumor.
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备注/Memo
收稿日期:2025-1-31。
基金项目:2022年度南京市卫生科技发展专项资金项目计划(YKK22164)
通讯作者:莫绪明,Email:mohsuming15@sina.com