Ozger Harzem, Eralp Levent, Toker Berkin, Ağaoğlu Fulya, Dizdar Yavuz
Istanbul University Istanbul Medical School, Department of Orthopaedics and Traumatology, Istanbul.
Acta Orthop Traumatol Turc. 2007 Aug-Oct;41(4):291-4.
We investigated treatment results and the role of potential prognostic factors in patients treated by surgery with or without adjuvant radiotherapy for primary or recurrent extra-abdominal desmoid tumors.
The study included 38 patients (23 females, 15 males; mean age 24 years; range 5 to 61 years) who underwent surgical treatment for extra-abdominal desmoid tumors. Of these, eight patients (21.1%) already had recurrences before treatment. Involvement was in the upper extremity in 12 cases (31.6%), in the lower extremity in 22 cases (57.9%), and in the axial region in four cases (10.5%). Twenty-two patients received adjuvant radiotherapy following surgical resection. Survival was analyzed by the Kaplan-Meier method. The mean follow-up period was 7.3 years (2.5 to 228 months).
Twenty patients (52.6%) developed recurrences after treatment. Of these, recurrences were already present in six patients, and adjuvant radiotherapy was administered to 11 patients (55%). Recurrences developed at the irradiated site in eight patients, and in other regions in three patients. The mean disease-free survival was 38+/-8 months, and eight-year disease-free survival was 35.7+/-8.5%. Disease-free survival did not differ significantly between patients receiving adjuvant radiotherapy (47.9+/-7.9 months) and those treated with surgery alone (37.9+/-12.4 months), and between patients who developed a recurrence at the resection site (12.1+/-4.7 months) or at a different site (24.3+/-1.0 months) (p>0.05). None of the potential prognostic factors including gender, age, localization, surgical margin, or adjuvant irradiation were found to affect disease-free survival.
In our series, no prognostic factor could be identified as having an association with the high recurrence rate.
我们研究了接受手术治疗(有或无辅助放疗)的原发性或复发性腹外硬纤维瘤患者的治疗结果及潜在预后因素的作用。
该研究纳入了38例接受腹外硬纤维瘤手术治疗的患者(23例女性,15例男性;平均年龄24岁;范围5至61岁)。其中,8例患者(21.1%)在治疗前已经复发。病变累及上肢12例(31.6%),累及下肢22例(57.9%),累及轴区4例(10.5%)。22例患者在手术切除后接受了辅助放疗。采用Kaplan-Meier法分析生存率。平均随访期为7.3年(2.5至228个月)。
20例患者(52.6%)在治疗后复发。其中,6例患者复发时已存在,11例患者(55%)接受了辅助放疗。8例患者在放疗部位复发,3例患者在其他部位复发。平均无病生存期为38±8个月,8年无病生存率为35.7±8.5%。接受辅助放疗的患者(47.9±7.9个月)与单纯手术治疗的患者(37.9±12.4个月)之间,以及在切除部位复发的患者(12.1±4.7个月)与在不同部位复发的患者(24.3±1.0个月)之间,无病生存期无显著差异(p>0.05)。未发现包括性别、年龄、部位、手术切缘或辅助放疗在内的任何潜在预后因素影响无病生存期。
在我们的系列研究中,未发现有预后因素与高复发率相关。