摘要
目的探讨神经母细胞瘤(NB)患儿原发肿瘤手术切除程度与生存预后的关系。方法选取2011年5月至2015年7月间四川省成都市妇女儿童中心医院收治的行手术切除治疗的91例NB患儿,按照原发肿瘤手术切除程度不同分为两组,其中31例手术切除<90%原发病灶的患儿纳入A组,60例手术切除≥90%原发病灶的患儿纳入B组,比较两组患儿的临床疗效及不良反应。随访截止至2018年7月31日,记录患儿的生存情况,分析手术切除程度与生存预后的关系。结果 A组患儿治疗后总有效率为45. 2%,明显低于B组的91. 7%,差异有统计学意义(P <0. 05)。随访截止时,91例患者中存活34例,总生存率为37. 6%。单因素分析结果显示,NB患儿生存情况与临床分期、配合化疗、神经元特异性烯醇化酶(NSE)、远处转移及手术切除程度有关,差异均有统计学意义(均P <0. 05)。A组患者平均生存时间为(19. 42±6. 25)个月,明显低于B组的(50. 74±13. 16)个月,两组比较,差异有统计学意义(P <0. 05)。Cox回归分析结果表明,配合化疗和手术切除程度是NB患儿总体生存时间的独立影响因素,差异均有统计学意义(均P <0. 05)。结论配合化疗和手术切除原发病灶程度可影响NB患儿的生存预后,临床治疗时,应综合考虑患儿身体状况,选择手术切除范围。
Objective To study the relationship between the degree of resection and survival and prognosis in children with primary neuroblastoma( NB). Methods From May 2011 to July 2015,91 children with NB underwent surgical resection at Chengdu Women and Children Center Hospital were selected.They were were divided into two groups according to the degree of resection. Thirthy-one patients with surgical resection < 90% of primary lesions were included in group A. Sixty patients with surgical resection≥ 90% were included in group B. The curative efficacy and adverse reactions were analyzed and compared between the two groups. All the patients were followed up until July 31,2018,and their survival and prognosis were analyzed. Results The overall efficacy rate was 45. 2% in group A which was significantly lower than 91. 7% of group B( P < 0. 05). Among the 91 patients who were followed up unril July 31,2018,34 patients survived,and the overall survival rate was 37. 6%. Univariate analysis showed that the survival condition was related to clinical staging,chemotherapy,euron-specific enolase( NSE),distant metastasis and surgical resection( all P < 0. 05). The mean survival time was( 19. 42 ± 6. 25) months for group A which was significantly lower than( 50. 74 ± 13. 16) months of group B( P < 0. 05). The results of Cox regression analysis showed that the degree of resection and chemotherapy were time-independent factors for the overall survival in children with NB( P < 0. 05). Conclusion Chemotherapy,the degree of surgical resection of primary lesions may have an effect on the survival and prognosis in children with NB. In clinical practice,physiclal status should be considered synthetically to decide the resection range in children.
作者
闫焕
杨正兵
YAN Huan;YANG Zheng-bin(Department of Pediatric Surgery,Chengdu Women and Children Center Hospital,Chengdu 610000,China)
出处
《中国肿瘤临床与康复》
2019年第3期280-283,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
作者简介
闫焕,男,主治医师,主要从事小儿外科专业。
