边缘和恶性植物瘤的外科边缘和预后
Jialin Su1, Shanling Liu2, Gang Tu3
1Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
概括
至少达到1厘米的外科手术边缘对于边界和恶性花瘤 (PTs) 来说至关重要. 较小的边缘增加了复发风险,特别是在年轻的患者或具有较大的瘤的患者中.
科学领域:
- 在瘤学瘤学.
- 手术病理学手术病理学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 乳腺瘤 (Phyllodes tumors,PTs) 是一种罕见的乳腺纤维皮质瘤.
- 边缘性和恶性PT具有局部复发和远程转移的显著风险.
- 对这些侵袭性PT亚型的最佳手术管理和预后因素需要进一步阐明.
研究的目的:
- 确定理想的外科边缘,以实现边缘和恶性PT的良好结果.
- 在PT患者中确定与局部无复发生存率 (LRFS) 和无疾病生存率 (DFS) 相关的独立预后风险因素.
主要方法:
- 对150名边缘性和恶性PT患者 (2011-2022) 的回顾性分析.
- 使用单变量和多变量考克斯比例危险模型.
- 手术边缘,年龄和瘤大小对LRFS和DFS的评估影响.
主要成果:
- 与手术边缘≥1厘米的患者相比,与边缘<1厘米的患者相比,手术边缘≥1厘米的患者表现出明显更好的5年LRFS和DFS率.
- 重新手术以达到≥1厘米的边际改善了LRFS和DFS在最初边际较小的患者中.
- 对LRFS的独立风险因素包括手术边缘<1厘米和年龄<45岁.
- DFS的独立风险因素包括手术边缘<1厘米和瘤大小>5厘米.
结论:
- 对于边缘性和恶性PT,建议进行至少1厘米的负手术边缘,必要时进行二次切除.
- 瘤大小>5厘米和年龄<45岁是复发的预测因素.
- 建议在具有这些预后因素的高风险患者考虑多式疗法.
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