皮肤平滑肌肉瘤：采用标准化切缘的治疗和结果。
Cutaneous leiomyosarcoma: treatment and outcomes with a standardized margin of resection.
机构信息
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA.
出版信息
Cancer Control. 2013 Oct;20(4):307-12. doi: 10.1177/107327481302000408.
BACKGROUND
Cutaneous leiomyosarcoma is primarily a low-grade malignancy that affects elderly male Caucasians. It is a rare dermal-based tumor for which treatment algorithms have been poorly defined.
METHODS
We retrospectively reviewed the use of a median 1-cm margin for resection to treat patients with cutaneous leiomyosarcoma referred for treatment between 2005 and 2010.
RESULTS
Thirty-three patients with cutaneous leiomyosarcoma were treated. Of these, 76% were male, 97% were Caucasian (median age: 63.5 years), and 67% of tumors were located on the extremities. Preoperative staging was negative for distant metastasis in all patients. A majority of the tumors (88%) were low grade (median size: 1.3 cm). All of the tumors were positive for smooth-muscle actin. A total of 94% of patients underwent primary surgical resection with a median margin of 1 cm. Final resection margin was negative in 97% of patients. Adjuvant radiotherapy was used in 15%. No metastatic spread or recurrences were present, and 100% of patients were alive at last follow-up (median: 15.5 months).
CONCLUSIONS
Good oncological control and excellent outcomes are possible with a 1-cm resection margin in most cases of cutaneous leiomyosarcoma.
背景
皮肤平滑肌肉瘤主要是一种低度恶性肿瘤，影响老年白人男性。它是一种罕见的皮肤基底肿瘤，其治疗方案尚未明确。
方法
我们回顾性分析了 2005 年至 2010 年间接受治疗的 33 例皮肤平滑肌肉瘤患者的 1cm 中位切缘切除术的应用。
结果
33 例皮肤平滑肌肉瘤患者接受了治疗。其中，76%为男性，97%为白人（中位年龄：63.5 岁），67%的肿瘤位于四肢。所有患者术前均未发现远处转移。大多数肿瘤（88%）为低度（中位大小：1.3cm）。所有肿瘤均为平滑肌肌动蛋白阳性。94%的患者接受了原发性手术切除，中位切缘为 1cm。97%的患者最终切缘为阴性。15%的患者接受了辅助放疗。无转移扩散或复发，最后一次随访时所有患者均存活（中位随访时间：15.5 个月）。
结论
在大多数皮肤平滑肌肉瘤病例中，1cm 的切缘切除可获得良好的肿瘤控制和良好的预后。
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