摘要
目的 :进一步提高临床医师对隆凸性皮肤纤维肉瘤 (DFSP)的认识 ,探讨规范化的手术方法和综合治疗途径。方法 :对本院 1985年 1月～ 2 0 0 1年 10月收治的 6 4例复发性隆凸性皮肤纤维肉瘤病例 ,进行临床和病理资料的回顾性分析。结果 :6 4例复发病例中 ,5 7例入院前有局部切除手术史 ,明显多于有广泛切除手术史者 (7例 )。入院后有 5 3例施行广泛切除手术治疗 ,其中 4 1例皮肤切缘≥ 3cm ,12例皮肤切缘在 1～ 2cm ,经随访术后两者出现局部再复发分别有 3例 (7.3% )和 2例 (16 .7% )。 6 4例病例中 ,共有 8例在复发后直接施行或再手术后施行放射治疗 ,放疗后局部复发 2例 ,均为以往多次手术后复发的病例。全部病例中 ,只有 2例 (3.1% )死亡。结论 :隆凸性皮肤纤维肉瘤局部手术切除后有较高的复发率 ,规范化的广泛切除手术是降低复发率的关键。对术后切缘(+)、身体状况不适合手术治疗等病例应用放射治疗仍不失为一种有效的治疗方法。临床医师应该重视手术的规范化 。
Purpose:Try to discuss the standardized surgical treatment and combined therapy in treating dematofibrosarcoma protuberans ( DFSP ).Methods:A retrospective review was done on 64 patients with pathologically confirmed recurrent dematofibrosarcoma protuberans who were treated in our hospital between January 1985 to October 2001. Results:Among the 64 recurrent cases, 57 had been given local excision before being admitted in our hospital, and the number was much more than those given wide excision (7cases). After admission in our hospital, 53 cases were given wide excision while 8 ones were given radiotherapy directly or after operation. 41 cases had excision margins ≥3cm and 3 of them (7.3%) developed local recurrence, 12 ones had excision margins 1～2 cm and 2 of them (16.7%) developed local failure. Among the 8 cases given radiotherapy, 2 developed local recurrence, both of them were those having had local excision and wide excision several times.Among all the 64 cases, only 2 (3.1%) were dead.Conclusions:DFSP has a high recurrent rate after local excision. Standardized wide excision is the key to reducing local failure. Adjuvant radiotherapy is an effective treatment for the patients with positive resection margin or the patients not suitable for surgical treatment. The clinician should emphasize that standardized surgical treatment and appropriate combination therapy be used.
出处
《中国癌症杂志》
CAS
CSCD
2002年第4期326-329,共4页
China Oncology
