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隆突性皮肤纤维肉瘤远处转移的危险因素。

Risk factors for distant metastasis of dermatofibrosarcoma protuberans.

作者信息

Hayakawa Keiko, Matsumoto Seiichi, Ae Keisuke, Tanizawa Taisuke, Gokita Tabu, Funauchi Yuki, Motoi Noriko

机构信息

Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.

Department of Pathology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.

出版信息

J Orthop Traumatol. 2016 Sep;17(3):261-6. doi: 10.1007/s10195-016-0415-x. Epub 2016 Jun 11.

Abstract

BACKGROUND

Dermatofibrosarcoma protuberans (DFSP) may recur locally but rarely metastasizes. Fibrosarcomatous transformation in dermatofibrosarcoma protuberans (FS-DFSP) is said to have worse prognosis compared with ordinary DFSP (O-DFSP). Since DFSP rarely metastasizes, there have been few reports summarizing data on distant metastasis cases at single institution. The aim of this retrospective study is to review DFSP cases in order to analyze risk factors for metastasis.

PATIENTS AND METHODS

This retrospective study involved 67 patients. We analyzed O-DFSP and FS-DFSP metastasis rates, metastasis sites, time to metastasis, the relationship between frequency of local recurrence and metastasis, and the relationship between primary tumor size and metastasis.

RESULTS

Distant metastasis was found in 5 (7.4 %) of 67 cases with DFSP. Of the five cases, the histopathological diagnosis was FS-DFSP in four cases and O-DFSP in one case. Out of five cases with metastasis, three had not recurred and two had recurred twice. No clear correlation was identified (Fisher's exact test: p = 0.216). The primary tumor diameters in the metastatic cases were 15.0, 12.6, 20.5, 13.0, and 5.0 cm, respectively. The tumor diameters in metastatic cases were significantly larger (Fisher's exact test: p < 0.0001).

CONCLUSIONS

In this study, we identified a stronger correlation between DFSP metastasis and tumor size. There was a high possibility that the cases with large tumors might be FS-DFSP, having high rate of metastasis and poor prognosis. In treatment of DFSP, early diagnosis before primary tumor growth and wide resection is considered important.

摘要

背景

隆突性皮肤纤维肉瘤(DFSP)可能局部复发,但很少发生转移。与普通DFSP(O-DFSP)相比,隆突性皮肤纤维肉瘤的纤维肉瘤样转化(FS-DFSP)据说预后更差。由于DFSP很少发生转移,因此很少有报告总结单一机构远处转移病例的数据。这项回顾性研究的目的是回顾DFSP病例,以分析转移的危险因素。

患者与方法

这项回顾性研究纳入了67例患者。我们分析了O-DFSP和FS-DFSP的转移率、转移部位、转移时间、局部复发频率与转移之间的关系,以及原发肿瘤大小与转移之间的关系。

结果

67例DFSP患者中有5例(7.4%)发生远处转移。在这5例中,组织病理学诊断为FS-DFSP的有4例,O-DFSP的有1例。在5例转移患者中,3例未复发,2例复发两次。未发现明显相关性(Fisher精确检验:p = 0.216)。转移病例的原发肿瘤直径分别为15.0、12.6、20.5、13.0和5.0 cm。转移病例的肿瘤直径明显更大(Fisher精确检验:p < 0.0001)。

结论

在本研究中,我们发现DFSP转移与肿瘤大小之间存在更强的相关性。肿瘤较大的病例很可能是FS-DFSP,转移率高且预后差。在DFSP的治疗中,在原发肿瘤生长前进行早期诊断和广泛切除被认为很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ac/4999380/657e8c94b5bd/10195_2016_415_Fig1_HTML.jpg

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