Postoperative application of multidisciplinary treatment in patients with hepatobiliary and pancreatic malignancies
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摘要:
目的对以病理结果为基础的肝胆胰恶性肿瘤术后多学科协作组(MDT)诊治的应用进行探讨。方法分析2014年4月-2015年3月在吉林大学第一医院诊治的肝胆胰恶性肿瘤患者术后MDT治疗的临床资料。MDT治疗方案以会诊形式进行,隔周进行1次,每次会诊病例数约为46例,会诊专家统一讨论制订患者术后综合治疗方案。分析术后MDT会诊治疗效果及预后情况。结果肝胆胰肿瘤术后MDT会诊共进行25次,会诊病例131例,包括肝细胞癌53例、胆管细胞癌7例、混合型肝癌1例、转移性肝癌3例、肝肉瘤2例、胆管癌29例、胰腺癌22例、胆囊癌5例、壶腹周围癌9例。术后完成介入治疗38例,全身化疗19例,放疗15例,细胞生物治疗17例,分子靶向药物治疗5例。定期随访中病死率2.29%(3/131)。结论肝胆胰恶性肿瘤术后MDT的应用能弥补术前MDT的不足,为患者提供科学合理的个体化综合治疗方案,并能提高患者依从性,具有较好的推广意义。
Abstract:Objective To investigate postoperative application of multidisciplinary treatment( MDT) in hepatobiliary and pancreatic malignancies based on the pathological results. Methods The clinical data of patients who were diagnosed as hepatobiliary and pancreatic malignancies who were diagnosed and treated with postoperative MDT in our hospital from Apirl 2014 to March 2015 were analyzed. MDT was performed by consultation for four to six patients once every other week. The postoperative comprehensive treatment strategy for each patient was discussed and determined by all experts in the consultation. The effect of postoperative treatment and prognosis was summarized. Results25 postoperative MDT consultations on hepatobiliary and pancreatic malignancies were held for 131 patients,including 53 patients with hepatocellular carcinoma,7 patients with intrahepatic cholangiocarcinoma,one patient with mixed-type liver cancer,3 patients with metastatic liver cancer,2 patients with liver sarcoma,29 patients with extrahepatic cholangiocarcinoma,22 patients with pancreatic cancer,5 patients with gallbladder cancer,and 9 patients with periampullary cancer. After surgery,38 patients received interventional treatment,19 systemic chemotherapy,15 radiotherapy,17 cell biotherapy,and 5 molecularly targeted therapy. The case fatality rate was 2. 29%( 3 /131). Conclusion Postoperative MDT provides scientific and rational personalized comprehensive treatment for patients with hepatobiliary and pancreatic malignancies,and improves medication compliance in patients,which holds promise for wide application.
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