Lehnhardt Marcus, Weskamp Pia, Sogorski Alexander, Reinkemeier Felix, von Glinski Maxi, Behr Björn, Harati Kamran
Klinik für Plastische Chirurgie und Handchirurgie, Schwerbrandverletztenzentrum, Sarkomzentrum, BG-Universitätsklinikum Bergmannsheil Bochum, Bochum, Germany.
Handchir Mikrochir Plast Chir. 2023 Apr;55(2):106-113. doi: 10.1055/a-1948-2239. Epub 2023 Feb 9.
Aggressive fibromatosis, histologically classified as benign due to the absence of metastasis, is characterised by locally invasive and destructive growth with high recurrence rates after resection. For this reason, prognostic recurrence factors, in particular the extent of resection, are much debated, and treatment decisions seem challenging for interdisciplinary tumour conferences. Between the years 2000 and 2020, 110 patients with aggressive fibromatosis of the extremities or trunk received surgical treatment at BG University Hospital Bergmannsheil (Bochum, Germany). Univariate analyses were performed to detect any potential prognosis factors. The median follow-up time was 5.9 years. A total of 57 (51.8%) of these patients developed recurrence during this period. The 5-year recurrence-free survival was 52.9% (95% CI: 42.4-62.3) in the entire cohort. In R0-resected patients, the 5-year recurrence-free survival (RFS) was significantly better (p<0.001) at 69.2% compared with patients with R1 or R2-resected tumours (32.6%). Beyond that, no other significant influencing factors were identified. The results of this study indicate that R0 resection or R0 resectability were associated with a significantly better local control. The therapeutic recommendation for resection should be made individually by an interdisciplinary tumour board in due consideration of tumour progression, possible therapeutic alternatives, and foreseeable functional impairment.
侵袭性纤维瘤病，因其无转移而在组织学上被归类为良性，其特征是局部侵袭性和破坏性生长，切除后复发率高。因此，预后复发因素，尤其是切除范围，备受争议，对于跨学科肿瘤会议而言，治疗决策似乎颇具挑战性。在2000年至2020年期间，110例四肢或躯干侵袭性纤维瘤病患者在德国波鸿的贝格曼斯海尔BG大学医院接受了手术治疗。进行单因素分析以检测任何潜在的预后因素。中位随访时间为5.9年。在此期间，共有57例（51.8%）患者出现复发。整个队列的5年无复发生存率为52.9%（95%CI：42.4 - 62.3）。在R0切除的患者中，5年无复发生存率（RFS）显著更好（p<0.001），为69.2%，而R1或R2切除肿瘤的患者为32.6%。除此之外，未发现其他显著影响因素。本研究结果表明，R0切除或R0可切除性与显著更好的局部控制相关。切除的治疗建议应由跨学科肿瘤委员会根据肿瘤进展、可能的治疗选择和可预见的功能损害进行个体化制定。
