Skene A I, Barr L, A'Hern R P, Fisher C, Meirion Thomas J
Sarcoma and Melanoma Unit, Royal Marsden Hospital, London, UK.
Br J Surg. 1998 May;85(5):655-8. doi: 10.1046/j.1365-2168.1998.00642.x.
Deep musculoaponeurotic fibromatoses are rare soft tissue neoplasms with a propensity for local recurrence.
A retrospective analysis was carried out of the factors contributing to local disease control in 75 patients treated between 1963 and 1993.
Multivariate analysis identified the type of surgical excision (P < 0.001) and involvement of pathological resection margins (P < 0.02) as significant factors contributing to local recurrence. After a median follow up of 47 months (range 24 months to 29 years) 31 (49 per cent) of the 63 patients who had an 'adequate' surgical resection developed local recurrence. The median time before development of local recurrence was 83.4 (range 8-129) months in patients with clear pathological resection margins. This was significantly shortened to 13.1 (range 2-35) months in those with positive margins (P < 0.001).
Adequate surgical extirpation is the most important determinant in local disease control. Treatment of local recurrence ranged from observation during periods of disease stabilization to multimodality treatment for aggressive disease.
深部肌筋膜纤维瘤病是一种罕见的软组织肿瘤，有局部复发倾向。
对1963年至1993年间接受治疗的75例患者中影响局部疾病控制的因素进行回顾性分析。
多变量分析确定手术切除类型（P < 0.001）和病理切缘受累情况（P < 0.02）是导致局部复发的重要因素。在中位随访47个月（范围24个月至29年）后，63例接受“充分”手术切除的患者中有31例（49%）出现局部复发。病理切缘阴性的患者局部复发前的中位时间为83.4（范围8 - 129）个月。切缘阳性患者的这一中位时间显著缩短至13.1（范围2 - 35）个月（P < 0.001）。
充分的手术切除是局部疾病控制的最重要决定因素。局部复发的治疗范围从疾病稳定期的观察到针对侵袭性疾病的多模式治疗。
