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复发性癌症的眼眶内容剜除术:5年经验

Orbital Exenteration in Recurrence Cancer: 5 Years Experience.

作者信息

Barbera Giorgio, Todaro Mattia, Saponaro Gianmarco, Gasparini Giulio, Moro Alessandro

机构信息

Maxillo Facial Surgery Unit, Fondazione Policlinico Agostino Gemelli IRCCS Hospital, 8 Largo Agostino Gemelli, 00168 Rome, Italy.

出版信息

J Clin Med. 2023 Sep 25;12(19):6180. doi: 10.3390/jcm12196180.

Abstract

INTRODUCTION

The purpose of this study was to assess the overall survival (OS) and disease-free survival (DFS) of patients who underwent orbital exenteration for periorbital, conjunctival, and primary intraorbital carcinomas. Additionally, we assessed the outcomes of anterior retrograde temporalis muscle flap restoration.

METHODS

For all patients who had orbital exenteration in the previous five years, a non-comparative retrospective assessment of their medical records, histology, and radiographic imaging was carried out. We investigated the relationships between the various qualitative factors using Cramer's V Kaplan-Meier (KM) analysis. For each of the patient's categorical factors that were of relevance, estimates of the survival distribution were displayed, and log-rank tests were used to determine whether the survival distributions were equal.

RESULTS

This study looks at 19 participants. The sample is made up of 13 men (68%) and 6 women (32%). The degree of relationship (Cramer's V index) between lymph node metastases (N) and the existence of distant metastases (M) is high, at 64%, and is statistically significant because the -value is 0.0034 < 0.005. Lymph node metastases had a statistically significant impact on overall survival ( = 0.04 < 0.05). Thirteen of the nineteen patients tested had no palsy (68%). There was no one presenting a CSF leak.

CONCLUSION

Our findings show how crucial it is to identify any lymph node involvement that orbital neoplasms may have. In patients who have received many treatments, sentinel lymph node biopsy (SLNB) may be used to determine the stage and spread of the cancer. To determine whether additional tumor characteristics may be explored, more expertise in the SLNB field for patients with orbital cancer who have received many treatments may be helpful. To prevent additional scarring and to be comparable to previous techniques for facial nerve lesions, the anterior retrograde approach and the transorbital procedure for temporal muscle flap in-setting are both effective methods.

摘要

引言

本研究的目的是评估因眶周、结膜及原发性眶内癌而行眼眶内容剜除术患者的总生存期(OS)和无病生存期(DFS)。此外,我们评估了逆行颞肌瓣修复术的效果。

方法

对过去五年内接受眼眶内容剜除术的所有患者的病历、组织学和影像学资料进行非对照性回顾性评估。我们使用克莱默V卡普兰-迈耶(KM)分析研究各种定性因素之间的关系。对于每个相关的患者分类因素,显示生存分布估计值,并使用对数秩检验确定生存分布是否相等。

结果

本研究观察了19名参与者。样本由13名男性(68%)和6名女性(32%)组成。淋巴结转移(N)与远处转移(M)的关联程度(克莱默V指数)较高,为64%,且具有统计学意义,因为P值为0.0034<0.005。淋巴结转移对总生存期有统计学显著影响(P = 0.04<0.05)。19名接受检测的患者中有13名无麻痹(68%)。无人出现脑脊液漏。

结论

我们的研究结果表明识别眼眶肿瘤可能存在的任何淋巴结受累情况至关重要。在接受过多种治疗的患者中,前哨淋巴结活检(SLNB)可用于确定癌症的分期和扩散情况。对于接受过多种治疗的眼眶癌患者,在SLNB领域积累更多专业知识可能有助于确定是否可探索其他肿瘤特征。为防止额外的瘢痕形成并与先前的面神经病变技术相媲美,逆行颞肌瓣植入的前向逆行入路和经眶手术都是有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5e5/10573591/6cd140e418c9/jcm-12-06180-g001.jpg

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