The largest single-center report on intravenous leiomyomatosis and development of a classification to guide surgical management.

IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Journal of vascular surgery. Venous and lymphatic disorders Pub Date : 2024-10-11 DOI:10.1016/j.jvsv.2024.101989
Yulin Wen, Guotao Ma, Qi Miao, Jiang Shao, Wei Lu, Xingrong Liu, Chaoji Zhang, Jianzhou Liu, Dongyan Cao, Ninghai Chen, Jinhui Wang
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Abstract

Background: Intravenous leiomyomatosis (IVL) is a rare neoplasm; the accumulated knowledge about the characteristics and prognosis of this tumor has been derived mainly from isolated case reports with no comprehensive research. In this study, we reviewed our institution's experience with IVL over a 20-year period and developed a classification system that can be used to guide surgical management.

Methods: The study had a retrospective cohort design and included patients who underwent resection of IVL at our institution between January 2002 and December 2022. Perioperative parameters were then collected among four stages of our proposed classification. The long-term outcomes, oncologic prognosis, and factors associated with recurrence were analyzed.

Results: A total of 216 patients were included (stage 1, n = 92; stage 2, n = 39; stage 3, n = 76; stage 4, n = 9). The mean follow-up duration was 26.34 months, during which 18 patients (9.7%) in the complete resection group had recurrence, and 12 (39.0%) in the incomplete resection group showed disease progression. Recurrence or progression of residual disease was associated with adjuvant aromatase inhibitor therapy and maximum tumor thrombus diameter but not with total hysterectomy and bilateral salpingo-oophorectomy, age, or postoperative treatment with a gonadotropin-releasing hormone agonist therapy.

Conclusions: This is the largest single-center report on IVL published to date and provides valuable information on its clinical features and long-term outcomes, as well as surgical technique. Our classification system can be used to evaluate the extent of lesion involvement and guide surgical management.

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最大的单个中心静脉细肌瘤病报告,并制定了指导手术治疗的分类方法。
背景:静脉内雷肌瘤病(IVL)是一种罕见的肿瘤,关于这种肿瘤的特征和预后的知识主要来自于个别病例的报道,没有全面的研究。在这项研究中,我们回顾了本院20年来在IVL方面的经验,并建立了一套可用于指导手术治疗的分类系统:研究采用回顾性队列设计,纳入了 2002 年 1 月至 2022 年 12 月期间在我院接受 IVL 切除术的患者。然后,根据我们提出的分类方法,收集了4个分期的围手术期参数。分析了长期疗效、肿瘤预后以及与复发相关的因素:共纳入 216 例患者(1 期,92 例;2 期,39 例;3 期,76 例;4 期,9 例)。平均随访时间为 26.34 个月,在此期间,完全切除组有 18 名患者(9.7%)复发,不完全切除组有 12 名患者(39.0%)病情恶化。残留疾病的复发或进展与芳香化酶抑制剂辅助治疗和肿瘤血栓最大直径有关,但与全子宫切除术和双侧输卵管切除术、年龄或术后促性腺激素释放激素激动剂治疗无关:这是迄今为止发表的关于 IVL 的最大规模的单中心报告,提供了有关其临床特征、长期疗效以及手术技巧的宝贵信息。我们的分类系统可用于评估病变累及范围并指导手术治疗。
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来源期刊
Journal of vascular surgery. Venous and lymphatic disorders
Journal of vascular surgery. Venous and lymphatic disorders SURGERYPERIPHERAL VASCULAR DISEASE&n-PERIPHERAL VASCULAR DISEASE
CiteScore
6.30
自引率
18.80%
发文量
328
审稿时长
71 days
期刊介绍: Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.
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