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评价 85 例(2000-2013 年)初次切除不充分的皮肤肥大细胞瘤后瘢痕修复的效果。

Evaluation of scar revision after inadequate primary excision of cutaneous mast cell tumors in 85 dogs (2000-2013).

机构信息

Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA.

出版信息

Vet Surg. 2021 May;50(4):807-815. doi: 10.1111/vsu.13619. Epub 2021 Mar 5.

Abstract

OBJECTIVE

To determine the frequency of residual tumor, and factors associated with local recurrence and disease progression in dogs with incompletely excised mast cell tumors (MCT) following scar revision surgery.

STUDY DESIGN

Retrospective study.

ANIMALS

Eighty-five dogs.

METHODS

Medical records from January 2000 to April 2013 were reviewed. Dogs with scar revision surgery after incomplete primary MCT excision were included. Recorded were signalment; initial tumor size, location and grade; time interval between primary excision and scar revision surgery; presence of MCT in the resected scar; local recurrence, lymph node metastasis, systemic metastasis, and cause of death.

RESULTS

Eighty six tumors in 85 dogs were studied. Residual MCT was found in 23 (27%) resected scars. Seven (8%) scars with residual MCT had incomplete or narrow margins. Follow-up was available for 68 dogs (69 tumors; median 403 days; range 4-2939). Local recurrence was reported in three (4%) dogs at 212, 555, and 993 days. Disease progressed in 10 dogs (14.5%) with regional or systemic metastasis at a median of 207 days (64-1583). Margin status and presence of MCT in the resected scar were not associated with local recurrence or disease progression. Lymph node metastasis (p = .004), locoregional recurrence (p = .013), and disease progression (p = .001) were significantly more likely in Grade III tumors.

CONCLUSION

Twenty-seven percent of resected scars contained residual MCT, but recurrence was uncommon after surgical revision.

CLINICAL SIGNIFICANCE

Clinicians should primarily consider tumor grade when estimating the likelihood of local recurrence and disease progression and determining the need for ancillary treatment of MCT after scar resection.

摘要

目的

确定不完全切除肥大细胞瘤(MCT)后行瘢痕修整术的犬残留肿瘤的频率,以及与局部复发和疾病进展相关的因素。

研究设计

回顾性研究。

动物

85 只狗。

方法

回顾 2000 年 1 月至 2013 年 4 月的病历。纳入行不完全原发性 MCT 切除后行瘢痕修整术的犬。记录的信息包括:品种;初次肿瘤大小、位置和分级;原发性切除与瘢痕修整手术之间的时间间隔;切除的瘢痕中是否存在 MCT;局部复发、淋巴结转移、全身转移和死亡原因。

结果

85 只犬的 86 个肿瘤被研究。23 个(27%)切除的瘢痕中发现有残留的 MCT。7 个(8%)有残留 MCT 的瘢痕边缘不完整或狭窄。68 只(69 个肿瘤;中位数为 403 天;范围 4-2939)可获得随访。3 只(4%)犬分别在 212、555 和 993 天报告局部复发。10 只(14.5%)犬出现区域或全身转移,疾病进展中位数为 207 天(64-1583)。边缘状态和切除瘢痕中是否存在 MCT 与局部复发或疾病进展无关。淋巴结转移(p=0.004)、局部区域复发(p=0.013)和疾病进展(p=0.001)在 III 级肿瘤中更常见。

结论

27%切除的瘢痕中含有残留的 MCT,但手术后复发并不常见。

临床意义

临床医生在估计局部复发和疾病进展的可能性以及确定瘢痕切除后 MCT 辅助治疗的必要性时,应主要考虑肿瘤分级。

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