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骨造釉细胞瘤:46例连续患者的长期随访

Adamantinoma of bone: Long-term follow-up of 46 consecutive patients.

作者信息

Houdek Matthew T, Sherman Courtney E, Inwards Carrie Y, Wenger Doris E, Rose Peter S, Sim Franklin H

机构信息

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida.

出版信息

J Surg Oncol. 2018 Dec;118(7):1150-1154. doi: 10.1002/jso.25269. Epub 2018 Oct 17.

Abstract

BACKGROUND

Adamantinomas are rare bone tumors, commonly affecting the tibia. Due to the rare nature of disease, previous studies are small or from multiple centers. The purpose of this study is to investigate outcomes of patients with adamantinoma treated in a single institution.

METHODS

Forty-six histological confirmed adamantinomas of the extremities were reviewed at our institution between 1939 and 2012. Follow-up data included clinical and radiographical information focusing on complications, local recurrence, metastasis, and overall survival after the treatment. The mean follow-up was 16 years (range 2-42 years).

RESULTS

The most common location was the tibia (n = 31). Patients commonly presented with pain and swelling. The mean age was 24 years (7-79 years). Thirty-seven patients were treated with limb salvage. The 39% of patients required a reoperation. The 10-year disease specific- and recurrence free survival was 92% and 72%, with three patients having a recurrence over 15 years postoperative. Older (> 20 years) patients and males were at increased risk of local recurrence (P < 0.05).

CONCLUSION

Treatment of adamantinoma of the long bone consists of limb-salvage surgery. Male patients should be cautioned on their increased risk of disease recurrence, and advocate for continued surveillance of patients even greater than 15-years postoperatively due to late tumor recurrence.

摘要

背景

造釉细胞瘤是一种罕见的骨肿瘤,常见于胫骨。由于该疾病的罕见性,以往的研究样本量较小或来自多个中心。本研究的目的是调查在单一机构接受治疗的造釉细胞瘤患者的治疗结果。

方法

回顾了1939年至2012年间在本机构确诊的46例四肢组织学造釉细胞瘤病例。随访数据包括临床和影像学信息,重点关注治疗后的并发症、局部复发、转移和总生存率。平均随访时间为16年(范围2 - 42年)。

结果

最常见的发病部位是胫骨(n = 31)。患者常见症状为疼痛和肿胀。平均年龄为24岁(7 - 79岁)。37例患者接受了保肢治疗。39%的患者需要再次手术。10年疾病特异性生存率和无复发生存率分别为92%和72%,3例患者在术后15年以上出现复发。年龄较大(> 20岁)的患者和男性局部复发风险增加(P < 0.05)。

结论

长骨造釉细胞瘤的治疗包括保肢手术。应提醒男性患者疾病复发风险增加,并提倡对患者进行持续监测,即使在术后15年以上,因为肿瘤可能会晚期复发。

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