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腹外硬纤维瘤:局部复发与治疗选择

EXTRA-ABDOMINAL DESMOID TUMOR: LOCAL RECURRENCE AND TREATMENT OPTIONS.

作者信息

Teixeira Luiz Eduardo Moreira, Arantes Eugênio Costa, Villela Rafael Freitas, Soares Claudio Beling Gonçalves, Costa Roberto Bitarães De Carvalho, Andrade Marco Antônio Percope De

机构信息

. Universidade Federal de Minas Gerais, Department of Orthopedics and Traumatology, Belo Horizonte, MG, Brazil.

出版信息

Acta Ortop Bras. 2016 May-Jun;24(3):147-50. doi: 10.1590/1413-785220162403142182.

Abstract

OBJECTIVE

To evaluate the rate of local recurrence of extra-abdominal desmoid tumor and compare the outcomes of surgical treatment and conservative treatment.

METHODS

Twenty one patients (14 women and seven men), mean age 33.0±8.7 years old, with a diagnosis of desmoid tumor were evaluated. The mean follow-up period was 58.5±29.0 months. Fourteen cases involved the lower limbs, four cases involved the upper limbs, and three cases involved the trunk. The average tumor size was 12.7±7.5 cm. Of the 21 patients, 14 did not undergo previous treatment and seven patients relapsed before the initial evaluation. Surgical treatment was performed in 16 patients and conservative treatment was performed in five patients.

RESULTS

Recurrence occurred in seven patients (33%) and six of them relapsed within the first 18 months. No significant difference was observed between conservative and surgical treatment. However, a significant difference was observed among patients undergoing wide resection and who experienced improved local control.

CONCLUSION

The recurrence rate of desmoid tumor was 33.3%. There was no difference in recurrence between conservative and surgical treatment. In surgical treatment, wide margins showed better results for recurrence control. Level of Evidence III. Retrospective Observational Study.

摘要

目的

评估腹外硬纤维瘤的局部复发率,并比较手术治疗和保守治疗的效果。

方法

对21例诊断为硬纤维瘤的患者(14例女性和7例男性)进行评估,平均年龄33.0±8.7岁。平均随访期为58.5±29.0个月。14例累及下肢,4例累及上肢,3例累及躯干。肿瘤平均大小为12.7±7.5 cm。21例患者中,14例未接受过先前治疗,7例在初次评估前复发。16例患者接受手术治疗,5例患者接受保守治疗。

结果

7例患者(33%)复发,其中6例在最初18个月内复发。保守治疗和手术治疗之间未观察到显著差异。然而,在接受广泛切除且局部控制得到改善的患者之间观察到显著差异。

结论

硬纤维瘤的复发率为33.3%。保守治疗和手术治疗的复发率无差异。在手术治疗中,切缘较宽对复发控制效果更好。证据等级III。回顾性观察研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/275c/4863863/ea28c587e7b7/1413-7852-aob-24-03-00147-gf1.jpg

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