副主任医师 肿瘤化疗
安徽省立医院
三级甲等美国外科医师协会发布了以下2项建议:
1、不要在没有尝试进行前哨淋巴结活检的情况下,对临床判断无淋巴结转移的临床分期为I或II期的乳腺癌患者进行腋窝淋巴结切除。
2、避免对生存预期小于10年,无结直肠肿瘤家族史和病史且无症状的患者进行结直肠肿瘤筛查。
此外,肿瘤委员会发布了以下5项建议:
3、对于可疑的乳房肿物,除非无法进行穿刺活检,否则不要进行外科手术去除肿物。
4、肿瘤治疗后,不要在为患者提供生存治疗计划之前进行定期监测。
5、不要在考虑全身术前新辅助化疗和/或放疗能否更加有效的控制局部肿瘤、提高生活质量或生存时间之前把手术作为初始治疗。
6、不要在制定出术后疼痛控制及肺炎预防的标准方案或路径之前进行大的腹部或胸部手术。
7、不要在通过临床分期确定肿瘤范围和与患者讨论治疗计划之前进行肿瘤治疗。
编译自:Seven Common Cancer Surgery Practices That Should Stop.Medscape Medical News,Sep09,2013
The Lists
The ACS has issued the following 2 recommendations:
1. Do not perform axillary lymph node dissection for clinical stageI or II breast cancer with clinically negative lymph nodes without attempting sentinel node biopsy.
2. Avoid colorectal cancer screening tests for asymptomatic patients with a life expectancy of less than 10 years and no family or personal history of colorectal neoplasia.
In addition, the Commission on Cancer has issued the following 5 recommendations:
3. Do not perform surgery to remove a breast lump for suspicious findings unless a needle biopsy cannot be done.
4. Do not initiate surveillance testing after cancer treatment without providing the patient with a survivorship care plan.
5. Do not use surgery as the initial treatment without considering whether presurgical (neoadjuvant) systemic and/or radiation therapy can be effective at improving local cancer control, quality of life, or survival.
6. Do not perform major abdominal surgery or thoracic surgery without a pathway or standard protocol for postoperative pain control and pneumonia prevention.
7. Do not initiate cancer treatment without defining the extent of the cancer (through clinical staging) and discussing the intent of treatment with the patient.
此文章内容仅代表医生观点,仅供参考。涉及用药、治疗等问题请到当地医院就诊,谨遵医嘱!
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