广泛局部切除与莫氏显微外科手术后隆突性皮肤纤维肉瘤复发情况：一项系统评价与Meta分析

Dermatofibrosarcoma Protuberans Recurrence After Wide Local Excision Versus Mohs Micrographic Surgery: A Systematic Review and Meta-Analysis.

作者信息

Martin Emma C St, Vyas Krishna S, Batbold Sarah, Erwin Patricia J, Brewer Jerry D

机构信息

Mayo Clinic Alix School of Medicine, Minnesota campus, Rochester, Minnesota.

Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.

出版信息

Dermatol Surg. 2022 May 1;48(5):479-485. doi: 10.1097/DSS.0000000000003411. Epub 2022 Mar 30.

DOI:10.1097/DSS.0000000000003411

PMID:35353755

Abstract

BACKGROUND

Local recurrence (LR) rates of dermatofibrosarcoma protuberans (DFSP) treated with different surgical modalities are unknown.

OBJECTIVE

To evaluate the differences in LR rates of DFSP treated with wide local excision (WLE) versus Mohs micrographic surgery (MMS).

MATERIALS AND METHODS

Pertinent studies of DFSP treated with either WLE or MMS were identified through a search of multiple databases, including Ovid MEDLINE (1946-2018), Embase (1988-2018), Web of Science (1975-2018), and Scopus (1970-2018). Comparative 2-arm and noncomparative single-arm studies were assessed through meta-analyses.

RESULTS

Of the 517 studies identified, 88 met inclusion criteria (12 comparative studies; 76 single-arm studies). In the 12 comparative studies, 352 patients with DFSP underwent MMS and 777 patients with DFSP underwent WLE. The LR rate was 1.7% after MMS and 3.7% after WLE (odds ratio, 1.549; 95% CI, 0.710-3.381; p = .27). In the 76 noncomparative studies, 980 patients underwent MMS (LR rate, 1.5%; 95% CI, 0.9%-2.1%; p < .001), and 2,215 patients underwent WLE (LR rate, 9.4%; 95% CI, 7.5%-11.3%; p < .001).

CONCLUSION

The LR rate of DFSP in patients treated with MMS is lower than in patients treated with WLE. Because of high rates of postoperative DFSP LR, MMS should be strongly considered when available.

摘要

背景

采用不同手术方式治疗隆突性皮肤纤维肉瘤（DFSP）的局部复发（LR）率尚不清楚。

目的

评估广泛局部切除（WLE）与莫氏显微外科手术（MMS）治疗DFSP的LR率差异。

材料与方法

通过检索多个数据库，包括Ovid MEDLINE（1946 - 2018年）、Embase（1988 - 2018年）、科学引文索引（1975 - 2018年）和Scopus（1970 - 2018年），确定有关WLE或MMS治疗DFSP的相关研究。通过荟萃分析评估比较性双臂研究和非比较性单臂研究。

结果

在检索到的517项研究中，88项符合纳入标准（12项比较性研究；76项单臂研究）。在12项比较性研究中，352例DFSP患者接受了MMS，777例DFSP患者接受了WLE。MMS后的LR率为1.7%，WLE后为3.7%（优势比，1.549；95%置信区间，0.710 - 3.381；p = 0.27）。在76项非比较性研究中，980例患者接受了MMS（LR率，1.5%；95%置信区间，0.9% - 2.1%；p < 0.001），2215例患者接受了WLE（LR率，9.4%；95%置信区间，7.5% - 11.3%；p < 0.001）。