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肢体和躯干软组织肉瘤的 MRI 和胸腹盆腔扫描仪系统局部和远程监测:一项单中心回顾性研究。

Limbs and trunk soft tissue sarcoma systematic local and remote monitoring by MRI and thoraco-abdomino-pelvic scanner: A single-centre retrospective study.

机构信息

Department of Radiology, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France; Department of Radiology, Centre Hospitalier Universitaire, 14 rue Paul Gaffarel, 21000, Dijon, France.

Department of Radiology, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France.

出版信息

Eur J Surg Oncol. 2019 Jul;45(7):1274-1280. doi: 10.1016/j.ejso.2019.02.002. Epub 2019 Feb 5.

Abstract

INTRODUCTION

Soft tissue sarcomas (STS) are rare malignant tumors that require management by an expert center. Monitoring modalities are not consensual. The objective of our study is to report systematic radiological monitoring data obtained by local MRI and by thoracic-abdominal-pelvic computed tomography (TAP CT).

MATERIAL AND METHODS

113 consecutive patients managed at "Centre Georges François Leclerc, Dijon", between 2008 and 2016, for an initially localized STS were included. Patient follow-up consisted of a local MRI and a TAP CT. Follow-up exams schedule was initially every 4 months during 2 years, followed by every 6 months during 3 years and finally every year during 5 years.

RESULTS

Median follow-up time was 37.2 months [min = 2.4 - max = 111.6]. After 5 years of surveillance, local recurrence (LR) rate was 8.8% and diagnosed by imaging in 60% of cases. No deep LR was clinically found. Median LR diagnosis time was 23.9 months [min = 2.0 - max = 52.4]. 50% of patients locally treated for their LR were alive without recurrence. Metastatic recurrence (MR) rate was 31%. 42.8% had extra-pulmonary involvement and 17.1% had exclusive extrathoracic metastases. The median time to diagnosis of MR was 17.4 months [min = 2.7- max = 77.2]. High-grade tumors relapsed more (20.4%) and earlier (all before the 5th year) than low grade.

CONCLUSION

Local MRI seems particularly suitable for monitoring deep tumors. In addition, the systematic monitoring by TAP CT highlighted a limited number of cases of exclusive extrathoracic metastases. The schedule of local and remote monitoring should primarily be adjusted to tumor grade.

摘要

介绍

软组织肉瘤(STS)是罕见的恶性肿瘤,需要由专家中心进行管理。监测方式尚无共识。我们的研究目的是报告通过局部 MRI 和胸腹部盆腔计算机断层扫描(TAP CT)获得的系统影像学监测数据。

材料和方法

纳入了 2008 年至 2016 年间在“Centre Georges François Leclerc,Dijon”接受治疗的 113 例局部 STS 患者。患者随访包括局部 MRI 和 TAP CT。随访检查计划最初每 4 个月进行一次,持续 2 年,然后每 6 个月进行一次,持续 3 年,最后每年进行一次,持续 5 年。

结果

中位随访时间为 37.2 个月[最小= 2.4-最大= 111.6]。5 年监测后,局部复发(LR)率为 8.8%,60%的病例通过影像学诊断。未发现深部 LR。LR 的中位诊断时间为 23.9 个月[最小= 2.0-最大= 52.4]。50%的 LR 局部治疗患者无复发且存活。转移复发(MR)率为 31%。42.8%有肺外累及,17.1%有单纯的胸外转移。MR 的中位诊断时间为 17.4 个月[最小= 2.7-最大= 77.2]。高级别肿瘤复发率更高(20.4%),复发时间更早(所有均在第 5 年之前)。

结论

局部 MRI 似乎特别适合监测深部肿瘤。此外,通过 TAP CT 进行系统监测突出了少数单纯胸外转移的病例。局部和远处监测的方案应主要根据肿瘤分级进行调整。

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