Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Surg Oncol. 2013 Jul;108(1):28-33. doi: 10.1002/jso.23343. Epub 2013 Apr 26.
We retrospectively reviewed the outcomes of desmoid tumor (DT) patients treated by surgical excision.
Among 155 consecutive patients, 119 patients satisfied our inclusion criteria. The mean follow-up duration was 82 months. Age, gender, location, size, depth, resection margin, adjuvant radiotherapy, and excision history were analyzed for the outcomes.
The recurrence-free survival (RFS) rates were 75% at 5 years and 72% at 10 years. Twenty-seven (93.1%) out of 29 recurrences were detected within 5 years. In multivariate analysis, positive resection margin and excision history were independently associated with the RFS. In the comparison between the propensity score matched groups, adjuvant radiotherapy was not significantly associated with the RFS. The mean time interval from surgery to recurrence was 30.0 ± 28.7 months (median, 20 months; range, 4-123 months). This interval was significantly longer for patients who received adjuvant radiotherapy than for those who received surgical resection only, both in all recurrences and in recurrences in matched cases.
Surgical excision appears to be a reliable treatment option for DTs. However, positive outcomes require a clear resection margin. Adjuvant radiotherapy may delay the recurrence of the tumor, although it seems to have no effect on the ultimate relapse rate.
我们回顾性分析了手术切除治疗硬纤维瘤（DT）患者的结局。
在 155 例连续患者中，有 119 例符合我们的纳入标准。平均随访时间为 82 个月。分析了年龄、性别、部位、大小、深度、切缘、辅助放疗和切除史与结局的关系。
5 年无复发生存率（RFS）为 75%，10 年 RFS 为 72%。29 例复发中有 27 例（93.1%）在 5 年内发现。多因素分析显示，阳性切缘和切除史与 RFS 独立相关。在倾向评分匹配组之间的比较中，辅助放疗与 RFS 无显著相关性。从手术到复发的平均时间间隔为 30.0±28.7 个月（中位数为 20 个月；范围为 4-123 个月）。接受辅助放疗的患者与仅接受手术切除的患者相比，无论是在所有复发患者中还是在匹配病例的复发患者中，复发的时间间隔都明显更长。
手术切除似乎是治疗 DT 的可靠选择。然而，阳性结果需要明确的切缘。辅助放疗可能会延迟肿瘤的复发，尽管它似乎对最终复发率没有影响。
