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医学摘要翻译

发表时间:2018-11-30  浏览次数:75  
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原文:

The urachal ligament is an embryologic remnant connecting the dome of the bladder to the umbilicus via the ligamentum commune. Autopsy series suggest that in approximately a third of subjects, the urachal remnant may persist with tubular or cystic structures. However, tumors of this site are extremely rare. Patients usually present with hematuria and upon imaging, have evidence of a cystic or solid structure in the bladder dome or in the bladder midline. If a biopsy confirms adenocarcinoma, these tumors should be considered an urachal cancer until proven otherwise. Although there are no prospective clinical trials reported to date, large single-institution reports suggest surgical resection with a partial cystectomy and en bloc resection of the urachal ligament with umbilicus as the treatment of choice in the setting of localized disease. Although there is currently no definitive role for neoadjuvant or adjuvant chemotherapy in this tumor, risk factors predicting progression may allow for the selection of patients at higher relapse risk for prospective studies. Unfortunately, there are many patients who present with metastatic disease that currently is not likely to be curable. There is no standard chemotherapy regimen for these patients; however, there is new-found hope with a currently accruing clinical trial exploring a 5-fluorouracil-based chemotherapy combination in this patient population.

 

译文:

脐尿管韧带是连接膀胱顶部和脐之间的胚胎残余。解剖结果表明大约三分之一的受试者,脐尿管残余可能存在管状或囊状结构。但是,这个部位的肿瘤极其罕见,病人通常出现血尿,并且成像表明膀胱顶部或中线处有囊状或实心结构。如果活检证实为腺癌,则这些肿瘤应该考虑为脐尿管癌,除非证实为其他疾病。虽然至今没有前瞻性临床试验报道,大型单一机构报道建议手术切除部分膀胱和整个脐尿管韧带(连同脐)来治疗局部病灶。虽然目前的新辅助疗法或辅助化疗对该肿瘤没有明确的作用,但预测疾病进展的危险因素可用于选择复发风险较高的患者进行前瞻性研究。不幸的是,目前很多患者出现无法治愈的转移性疾病。对这些患者来说,没有标准的化疗方案,然而目前出现的5氟尿嘧啶联合化疗临床试验是这类患者的新希望。

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