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Comprehensive diagnosis and treatment of alveolar echinococcosis: A single-center long-term observational study of 312 patients in Germany

機(jī)譯：肺泡棘球cc病的綜合診斷和治療：德國312位患者的單中心長期觀察性研究

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Alveolar echinococcosis (AE) is the most Iethal human helminthic infection. The malignancy-like disease is rare, but morbidity and treatment costs are high. Objective of the study was to identify factors at baseline and during specific AE therapy influencing the long-term outcome of the disease.All patients with AE seen at the specialized treatment unit in Ulm between January 1992 and December 2011 were included in the analysis.The data of 312 patients were analyzed; 108 were diagnosed before 2000 (series A), 204 since 2000 (series B); 290 received specific AE treatment. Patients of series B were more often symptom-free at diagnosis (44.1% vs. 21.3%), had lower disease stages (50.0% vs. 34.2%) and more complete resections (57.7% vs. 20.0%), but higher rates of side effects and drug toxicity (54.1% vs. 40.8%). In series B, more patients remained relapse- or progression-free after 5 years (90.5% vs. 82.8%); after 10 years, the ratio of relapses converged (70.3% vs. 66.9%, p=0.0507). Relapses or progression occurred more often after incomplete surgery or long treatment pauses. The 5-year and 10-year survival rates were 96.9% and 90.6%, respectively, and 17% of the patients were cured.We observed a shift towards early diagnosis, earlier initiation of specific therapy and more complete resections after 2000. Although diagnosis and treatment of AE pose a challenge, with an individual interdisciplinary management 88.8% of the patients have a favorable outcome.
機(jī)譯：肺泡棘球co病（AE）是人類最道德的蠕蟲感染。惡性腫瘤很少見，但發(fā)病率和治療費(fèi)用很高。這項研究的目的是確定基線和特定AE治療期間影響該疾病長期結(jié)果的因素。分析包括1992年1月至2011年12月在烏爾姆市專門治療單位見到的所有AE患者。分析了312例患者的數(shù)據(jù)； 2000年之前（A系列）診斷出108例，2000年以來（B系列）診斷出204例； 290名患者接受了特定的AE治療。 B系列患者診斷時更無癥狀（44.1％vs. 21.3％），疾病分期較低（50.0％vs. 34.2％），更完整的切除術(shù)（57.7％vs. 20.0％），但較高的發(fā)生率副作用和藥物毒性（54.1％對40.8％）。 B系列中，更多的患者在5年后仍無復(fù)發(fā)或無進(jìn)展（90.5％對82.8％）； 10年后，復(fù)發(fā)率趨同（70.3％對66.9％，p = 0.0507）。不完整的手術(shù)或長時間的治療暫停后，復(fù)發(fā)或進(jìn)展更為頻繁。 5年和10年生存率分別為96.9％和90.6％，治愈的患者為17％。我們觀察到2000年后轉(zhuǎn)向早期診斷，更早開始特異性治療和更完整的切除術(shù)。 AE的治療和治療構(gòu)成了挑戰(zhàn)，個體跨學(xué)科治療88.8％的患者預(yù)后良好。

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