手部腱鞘巨细胞瘤:影响复发的因素分析

Pub Date : 2024-02-21 eCollection Date: 2024-04-01 DOI:10.1055/s-0044-1779657
Pavan Venkateswar Kolisetty, Sheikh Sarfraz Ali, Imran Ahmad, Indrajith K Sudhy, Om Prakash, Y Ranga Kishore
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摘要

背景 手部腱鞘巨细胞瘤(GCTTS)被认为是仅次于神经节囊肿的第二大手部良性肿瘤。切除活检被认为是目前的标准治疗方法。许多研究表明,这种肿瘤的复发率非常高。据说肿瘤复发与许多因素有关。本研究的目的是评估在一家研究所接受手术的 48 例患者的长期疗效,并找出所提出的风险因素与复发之间是否存在关联。方法 对 2015 年至 2021 年期间接受手术的 GCTTS 病例进行回顾性分析。邀请患者进行至少两年的随访,并对患者档案进行审查。随访时收集了更多数据,包括复发、活动范围、感觉、皮肤坏死、瘢痕和数字神经病变。数据分析已经完成。用皮尔逊相关系数计算了所提出的风险因素与复发之间的相关性。P 值小于 0.05 即为具有统计学意义。结果 6 年间,48 名患者接受了手术。8名患者(16%)在手术后平均38.7个月复发。在风险因素中,肿瘤伴有卫星结节和肿瘤与关节相邻与复发有显著相关性。随访期间未发现并发症。结论 手部 GCTTS 复发倾向较高。出现卫星结节和靠近指间关节是复发的两个重要风险因素。手术放大可确保完全切除肿瘤,降低复发几率。
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Giant Cell Tumor of the Tendon Sheath of the Hand: Analysis of Factors Impacting Recurrence.

Background  Giant cell tumors of the tendon sheath (GCTTS) of the hand are considered the second most common benign tumors of the hand after ganglion cysts. Excision biopsy is considered the standard treatment at present. They are notorious for having a very high rate of recurrence as given in many studies. Many factors are said to be associated with recurrence of the tumors. The goal of this study is to evaluate the long-term results of a series of 48 patients operated on at a single institute and to find out if there is any correlation between the proposed risk factors with recurrence. Methods  A retrospective analysis was done in cases of GCTTS operated on between 2015 and 2021. The patients were invited for follow-up for a minimum of 2 years, and the patient files were reviewed. Further data were collected at follow-up including recurrence, range of movement, sensation, skin necrosis, scarring, and digital neuropathy. A data analysis was done. The correlation between the proposed risk factors and recurrence was calculated with the Pearson correlation coefficient. A p -value of less than 0.05 was considered statistically significant. Results  During the 6 years, 48 patients were operated on. Recurrence was observed in eight patients (16%) at an average of 38.7 months from the time of surgery. Of the risk factors, tumors with satellite nodules and tumor adjacency to joint correlated significantly with recurrence. No complications were observed during follow-up. Conclusion  GCTTS of the hand has a high propensity to recur. The presence of satellite nodules and proximity to interphalangeal joints are two important risk factors for recurrence. Magnification during surgery ensures complete excision of the tumor and reduces the chance of recurrence.

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