Department of Pediatric Orthopaedic, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China.
World J Surg Oncol. 2018 Dec 18;16(1):237. doi: 10.1186/s12957-018-1536-x.
Pediatric desmoid tumor (PDT) is rare and has a high local recurrence rate. The purpose of the present study was to analyze clinical risk factors of local recurrence in PDT patients.
We reviewed clinical data of 66 PDT patients from 2004 to 2015. All patients underwent macroscopically complete resection, and some recurrent tumors were prescribed radiotherapy. Factors such as sex, age at presentation, location, and proximity to nerves or vasculature were analyzed. The local recurrence rate and recurrence-free survival were analyzed with these factors.
All patients in the present study were children and had extra-abdominal tumors. The median follow-up time was 6.6 years. Thirty-six (55%) patients had local recurrence. Age, sex, tumor site, tumor size, and proximity to nerves/vasculature had a significant impact on prognosis in univariate analysis. Radiotherapy decreased the local recurrence rate. In multivariate analysis, younger age, tumor location in buttocks, larger tumor, and proximity to important nerves/vasculature were independent risk factors for poor prognosis.
Favorable therapeutic strategies could be selected according to the preoperative prognostic risk factors. Radiotherapy should be considered for local recurrence of PDT.
儿科硬纤维瘤（PDT）罕见，局部复发率高。本研究旨在分析 PDT 患者局部复发的临床危险因素。
回顾 2004 年至 2015 年间 66 例 PDT 患者的临床资料。所有患者均行大体完全切除，部分复发性肿瘤行放疗。分析性别、发病年龄、肿瘤位置及与神经或脉管的接近程度等因素。分析这些因素与局部复发率和无复发生存率的关系。
本研究所有患者均为儿童，且均为腹腔外肿瘤。中位随访时间为 6.6 年。36 例（55%）患者发生局部复发。单因素分析显示，年龄、性别、肿瘤部位、肿瘤大小和与神经/脉管的接近程度对预后有显著影响。放疗降低了局部复发率。多因素分析显示，年龄较小、肿瘤位于臀部、肿瘤较大和与重要神经/脉管接近是预后不良的独立危险因素。
可根据术前预后危险因素选择有利的治疗策略。对于 PDT 的局部复发，应考虑放疗。
