TGCT

TGCT
  • 文章类型: Journal Article
    睾丸癌(TCA)是一种罕见的恶性肿瘤,影响全球年轻男性。社会人口因素,特别是社会经济水平(SEL)和医疗保健准入,似乎影响TCA的发生率和结果,特别是在西班牙裔人群中。然而,有限的研究在西班牙裔人群中探索了这些变量。这项研究旨在调查墨西哥的社会人口统计学和临床因素及其在西班牙裔TCA患者健康差异中的作用。我们回顾性分析了2007年至2020年间来自国家参考癌症中心的具有不同社会背景的代表性队列的244例墨西哥TCA病例。Logistic回归确定死亡的危险因素:非精原细胞瘤组织学,高级阶段,和较低的教育水平。年龄作为危险因素表现出显著趋势。患者延误和医疗距离缺乏显著关联。在晚期,治疗反应不足和化疗耐药的可能性更大。而高等教育对治疗反应有积极影响。Cox回归突出非精原细胞瘤组织学,低于中位数的SEL,高等教育,和晚期生存率。基于肿瘤组织学和患者SEL出现生存差异。这项研究强调了整合社会人口统计学、生物,和环境因素来解决健康差异,通过个性化干预改善西班牙裔TCA患者的结局。
    Testicular cancer (TCa) is a rare malignancy affecting young men worldwide. Sociodemographic factors, especially socioeconomic level (SEL) and healthcare access, seem to impact TCa incidence and outcomes, particularly among Hispanic populations. However, limited research has explored these variables in Hispanic groups. This study aimed to investigate sociodemographic and clinical factors in Mexico and their role in health disparities among Hispanic TCa patients. We retrospectively analyzed 244 Mexican TCa cases between 2007 and 2020 of a representative cohort with diverse social backgrounds from a national reference cancer center. Logistic regression identified risk factors for fatality: non-seminoma histology, advanced stage, and lower education levels. Age showed a significant trend as a risk factor. Patient delay and healthcare distance lacked significant associations. Inadequate treatment response and chemotherapy resistance were more likely in advanced stages, while higher education positively impacted treatment response. Cox regression highlighted non-seminoma histology, below-median SEL, higher education, and advanced-stage survival rates. Survival disparities emerged based on tumor histology and patient SEL. This research underscores the importance of comprehensive approaches that integrate sociodemographic, biological, and environmental factors to address health disparities improving outcomes through personalized interventions in Hispanic individuals with TCa.
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  • 文章类型: Journal Article
    弥漫性腱膜巨细胞瘤(D-TGCT)膝关节周围的关节内和关节外扩张通常需要前后手术入路,以促进广泛的滑膜切除术。对于应该在一个或两个阶段中进行双侧活检,尚无共识。这项回顾性研究包括来自全球9个肉瘤中心的191名D-TGCT患者,以比较两种治疗方法的术后短期结果。次要结果是放射学进展率和后续治疗。在2000年至2020年之间,117例患者接受了一期手术,74例患者接受了二期手术。术后一年内达到的最大活动范围相似(屈曲123-120°,p=0.109;延伸0°,p=0.093)。接受两阶段滑膜切除术的患者在医院停留的时间更长(6vs.4天,p<0.0001)。并发症更经常发生在两个阶段的滑膜切除术后,尽管这在统计学上没有差异(36%与24%,p=0.095)。与接受一期synovecomies治疗的患者相比,接受两阶段synovecomies治疗的患者表现出更多的放射学进展,并且需要更多的后续治疗(52%vs.37%,p=0.036)(54%与34%,p=0.007)。总之,如果可行,需要双侧滑膜切除术的膝关节D-TGCT应采用一期滑膜切除术治疗,由于患者的运动范围相似,没有更多的并发症,但在医院待的时间要短一些.
    Diffuse-type tenosynovial giant cell tumors\' (D-TGCTs) intra- and extra-articular expansion about the knee often necessitates an anterior and posterior surgical approach to facilitate an extensive synovectomy. There is no consensus on whether two-sided synovectomies should be performed in one or two stages. This retrospective study included 191 D-TGCT patients from nine sarcoma centers worldwide to compare the postoperative short-term outcomes between both treatments. Secondary outcomes were rates of radiological progression and subsequent treatments. Between 2000 and 2020, 117 patients underwent one-stage and 74 patients underwent two-stage synovectomies. The maximum range of motion achieved within one year postoperatively was similar (flexion 123-120°, p = 0.109; extension 0°, p = 0.093). Patients undergoing two-stage synovectomies stayed longer in the hospital (6 vs. 4 days, p < 0.0001). Complications occurred more often after two-stage synovectomies, although this was not statistically different (36% vs. 24%, p = 0.095). Patients treated with two-stage synovectomies exhibited more radiological progression and required subsequent treatments more often than patients treated with one-stage synovectomies (52% vs. 37%, p = 0.036) (54% vs. 34%, p = 0.007). In conclusion, D-TGCT of the knee requiring two-side synovectomies should be treated by one-stage synovectomies if feasible, since patients achieve a similar range of motion, do not have more complications, but stay for a shorter time in the hospital.
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