精索脂肪肉瘤:最终手术干预的影响——一个机构经验。

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2016-01-01 Epub Date: 2016-04-14 DOI:10.1155/2016/4785394
R Bachmann, J Rolinger, P Girotti, H G Kopp, K Heissner, B Amend, A Königsrainer, R Ladurner
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引用次数: 15

摘要

背景:睾丸旁脂肪肉瘤几乎总是被误诊为腹股沟疝,随后又因手术不当。方法:对连续收治的14例睾丸旁脂肪肉瘤进行回顾性分析。评估术前管理。测定无病生存期和总生存期。结果:原发精索脂肪肉瘤11例,复发精索脂肪肉瘤3例。在初次手术干预中,14例患者中有7例(50%)为根治性(R0), 6例(43%)为边缘性(R1), 1例(7%)为不完全伴肉眼肿瘤残留(R2)。4例患者进行了初步治疗和二次手术干预:3例(75%)患者进行了根治性(R0)切除,1例(25%)患者进行了边缘性(R1)切除。对于复发性疾病的二次治疗,3例(100%)患者切除边缘(R1)。10例原发疾病患者(71%)的最终组织学边缘呈阴性,4例随后复发疾病患者的最终组织学边缘呈阳性。根治性切除后3年无病生存率为100%。4.5年(54(18-180)个月)总生存率为64%。结论:不完整的第一步手术增加了阳性切缘的数量,导致局部复发和不良预后。积极的手术应该尝试获得三维负切缘。
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Liposarcoma of the Spermatic Cord: Impact of Final Surgical Intervention--An Institutional Experience.

Background: Paratesticular liposarcomas are almost always mistakenly diagnosed as inguinal hernias subsequently followed by inadequate operation.

Methods: 14 consecutive patients with paratesticular liposarcoma were retrospectively reviewed. Preoperative management was evaluated. Disease-free and overall survival were determined.

Results: In 11 patients primary and in 3 patients recurrent liposarcoma of the spermatic cord were diagnosed. Regarding primary treatment in primary surgical intervention resection was radical (R0) in 7 of 14 (50%) patients, marginal (R1) in 6 (43%) patients, and incomplete with macroscopic residual tumour (R2) in 1 (7%) patient. Primary treatment secondary surgical intervention was performed in 4 patients: resection was radical (R0) in 3 (75%) patients and marginal (R1) in 1 (25%) patient. Regarding secondary treatment in recurrent disease resection was marginal (R1) in 3 patients (100%). Final histologic margins were negative in 10 patients with primary disease (71%) and positive in 4 patients with subsequent recurrent disease. After radical resection disease-free survival rates at 3 years were 100%. Overall survival at 4.5 years (54 (18-180) months) was 64%.

Conclusion: An incomplete first surgical step increases the number of positive margins leading to local recurrences and adverse prognoses. Aggressive surgery should be attempted to attain 3-dimensional negative margins.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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