隆突性皮肤纤维肉瘤的治疗及预后分析.pdfVIP

差用癌症杂志2 3月第23卷第2期 The Practical Journal of Cancer，March 2008．Vo1 23．No．2 · l77· 隆突性皮肤纤维肉瘤的治疗及预后分析 薛瑞峰 方志伟 多 健 陈 静 【摘要】 目的 探讨隆突性皮肤纤维肉瘤(DFSP)经广泛切除治疗后的临床疗效及预后情况。方法 回顾性分析 1985年1月至2006年1月在天津医科大学附属肿瘤医院接受治疗且资料完整的216例DFSP患者临床随访结果，对患 者的治疗及预后相关因素进行研究、比较。结果 患者入院后均接受广泛性切除治疗，194例(89．8％)达完全切除，16 例(7．4％)切缘阳性，另有6例(2．8％)切缘距肿瘤组织1 mm，22例切缘不理想的患者术后行辅助放疗。无复发组(A 组)及复发组(B组)的术后5年无瘤生存率分别为96．1％、81．4％，2组间比较，P=0．001。本组共有6例出现远处转 移，总死亡率为2．8％。结论 DFSP患者接受距肿瘤边缘2．5—3．5 cm的广泛性切除治疗，可获得较好的局部控制，整 体预后良好。肿瘤复发后浸润深度增加，切缘阳性率升高，最终导致无瘤生存率降低。多次复发切除有造成肿瘤细胞去 分化、致使其恶性程度增加及引起远处转移可能。 【关键词】 隆突性皮肤纤维肉瘤；复发；广泛切除；切缘 中图分类号：R739．5 文献标识码：A 文章编号：1001—5930(2008)02-0177-03 Treatment and Prognosis of Dermatofibrosareoma Protuberans XUE Rui-feng，FANG Zhi—wei，DUO Jian，et a1． Department ofBone and Tissue Tumor，Affiliated Tumor Hospital ofTianjin Medical University，Tianjin，300060 【Abstract】 Objective To investigate the treatment outcomes and prognosis of Dermatofibrosarcoma Protuberans(DFSP) treated by extensive excision．Methods We performed a retrospective analysis of the records of 216 patients with DFSP treated at our institution during January 1985 and January 2006 to evaluate the treatment outcomes and the prognostic factors．Recults All patients were treated by wide excision in which 194(89．8％)patients had negative margin，16(7．4％)patients had positive margins，and another 6 patients had close margins with distance between tumourl mm．The 22 patients with positive or close margins received postoperative radiotherapy．5-year disease free survival in the local control group was 96．1％ ．which was signifi— cant higher than that in the local recurrent group(81．4％，P=0．001)．6 patients developed distant metastasis．Total death rate was 2．8％ ．Conclusion Wide resection of DFSP with 2．5～3．5cm histological margins can obtain successful local con