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Abstract：
BACKGROUND: Various treatment options have been introduced for the management of primary tumors of the brachial plexus (BP), ranging from conservative therapy to wide local excision with/without postoperative chemoradiotherapy. However, no consensus exists regarding optimal treatment strategies based on collated and published data.
OBJECTIVE: The aim of this study was to investigate the clinicopathological characteristics and outcome of patients with primary tumors of the BP who underwent surgical treatment.
METHODS: A systematic search of the four main online databases, including Web of Science (WOS), PubMed, Scopus, and Google Scholar, was conducted.
METHODS: All related articles addressing the clinical outcome and role of surgical interventions for management of primary tumors of the BP.
METHODS: Optimal surgical and radiotherapeutic interventions for benign and malignant lesions based on the pathologic characteristics and location of primary BP tumors.
RESULTS: A total of 687 patients (693 tumors) with a mean age of 41.7±8.7 years old were evaluated. In total, 629 (90.8%) tumors were benign, and 64 (9.2%) were malignant, with a mean tumor size of 5.4±3.1 cm. The location of the tumor was reported for 639 patients. For these tumors, 444 (69.5%) originated from the supraclavicular region, and 195 (30.5%) were infraclavicular. The trunks were the most common location for tumor involvement, followed by the roots, cords, and terminal branches. Gross total resection was achieved in 432 patients and subtotal resection (STR) was performed in 109 patients. With neurofibromas, STR still resulted in good outcomes. The outcomes following treatment of malignant peripheral nerve sheath tumors were poor regardless of the type of resection. In general, symptoms related to pain and sensory issues resolved rapidly postoperatively. However, the resolution of motor deficits was often incomplete. Local tumor recurrence occurred in 15 (2.2%), patients and distant metastasis was observed in only eight (1.2%) cases. The overall mortality was 21 (3.1%) patients among the study population.
CONCLUSIONS: The main limitation was the lack of level I and II evidence.
CONCLUSIONS: The ideal management strategy for primary BP tumors is complete surgical resection. However, in some cases, particularly for neurofibromas, STR may be preferable to preserve maximal neurological function. The degree of surgical excision (total or subtotal) mainly depends on the pathological characteristics and primary location of the tumor.
OBJECTIVE: The aim of this study was to investigate the clinicopathological characteristics and outcome of patients with primary tumors of the BP who underwent surgical treatment.
METHODS: A systematic search of the four main online databases, including Web of Science (WOS), PubMed, Scopus, and Google Scholar, was conducted.
METHODS: All related articles addressing the clinical outcome and role of surgical interventions for management of primary tumors of the BP.
METHODS: Optimal surgical and radiotherapeutic interventions for benign and malignant lesions based on the pathologic characteristics and location of primary BP tumors.
RESULTS: A total of 687 patients (693 tumors) with a mean age of 41.7±8.7 years old were evaluated. In total, 629 (90.8%) tumors were benign, and 64 (9.2%) were malignant, with a mean tumor size of 5.4±3.1 cm. The location of the tumor was reported for 639 patients. For these tumors, 444 (69.5%) originated from the supraclavicular region, and 195 (30.5%) were infraclavicular. The trunks were the most common location for tumor involvement, followed by the roots, cords, and terminal branches. Gross total resection was achieved in 432 patients and subtotal resection (STR) was performed in 109 patients. With neurofibromas, STR still resulted in good outcomes. The outcomes following treatment of malignant peripheral nerve sheath tumors were poor regardless of the type of resection. In general, symptoms related to pain and sensory issues resolved rapidly postoperatively. However, the resolution of motor deficits was often incomplete. Local tumor recurrence occurred in 15 (2.2%), patients and distant metastasis was observed in only eight (1.2%) cases. The overall mortality was 21 (3.1%) patients among the study population.
CONCLUSIONS: The main limitation was the lack of level I and II evidence.
CONCLUSIONS: The ideal management strategy for primary BP tumors is complete surgical resection. However, in some cases, particularly for neurofibromas, STR may be preferable to preserve maximal neurological function. The degree of surgical excision (total or subtotal) mainly depends on the pathological characteristics and primary location of the tumor.
摘要：
背景：针对臂丛神经（BP）原发性肿瘤的治疗，已经引入了各种治疗方案，从保守治疗到有/没有术后放化疗的广泛局部切除术。然而,基于整理和发表的数据,对于最佳治疗策略尚无共识.
目的：本研究的目的是探讨接受手术治疗的BP原发肿瘤患者的临床病理特征和预后。
方法：对四个主要的在线数据库进行系统搜索，包括WebofScience(WOS),PubMed,Scopus,和谷歌学者，进行了。
方法：所有相关文章都讨论了手术治疗原发性BP肿瘤的临床结果和作用。
方法：根据原发性BP肿瘤的病理特征和位置，对良恶性病变进行最佳的手术和放射治疗。
结果：共评估了687例患者（693例肿瘤），平均年龄为41.7±8.7岁。总的来说,629（90.8%）肿瘤为良性，64例(9.2%)为恶性,平均肿瘤大小为5.4±3.1cm。报告了639例患者的肿瘤位置。对于这些肿瘤，444（69.5%）起源于锁骨上区域，195例（30.5%）位于锁骨下。树干是肿瘤受累最常见的位置，其次是根，绳索,和终端分支机构。432例患者实现了总切除，109例患者进行了次全切除（STR）。神经纤维瘤,STR仍然取得了良好的结果。无论切除类型如何，恶性周围神经鞘瘤的治疗结果均较差。总的来说,与疼痛和感觉问题相关的症状在术后迅速解决。然而,运动障碍的解决往往是不完整的。15例(2.2%)肿瘤局部复发,仅8例(1.2%)患者出现远处转移.在研究人群中，总死亡率为21例(3.1%)。
结论：主要限制是缺乏I级和II级证据。
结论：原发性BP肿瘤的理想治疗策略是完全手术切除。然而,在某些情况下,特别是对于神经纤维瘤，STR可能是优选的以保持最大的神经功能。手术切除的程度（全部或部分）主要取决于肿瘤的病理特征和原发位置。
目的：本研究的目的是探讨接受手术治疗的BP原发肿瘤患者的临床病理特征和预后。
方法：对四个主要的在线数据库进行系统搜索，包括WebofScience(WOS),PubMed,Scopus,和谷歌学者，进行了。
方法：所有相关文章都讨论了手术治疗原发性BP肿瘤的临床结果和作用。
方法：根据原发性BP肿瘤的病理特征和位置，对良恶性病变进行最佳的手术和放射治疗。
结果：共评估了687例患者（693例肿瘤），平均年龄为41.7±8.7岁。总的来说,629（90.8%）肿瘤为良性，64例(9.2%)为恶性,平均肿瘤大小为5.4±3.1cm。报告了639例患者的肿瘤位置。对于这些肿瘤，444（69.5%）起源于锁骨上区域，195例（30.5%）位于锁骨下。树干是肿瘤受累最常见的位置，其次是根，绳索,和终端分支机构。432例患者实现了总切除，109例患者进行了次全切除（STR）。神经纤维瘤,STR仍然取得了良好的结果。无论切除类型如何，恶性周围神经鞘瘤的治疗结果均较差。总的来说,与疼痛和感觉问题相关的症状在术后迅速解决。然而,运动障碍的解决往往是不完整的。15例(2.2%)肿瘤局部复发,仅8例(1.2%)患者出现远处转移.在研究人群中，总死亡率为21例(3.1%)。
结论：主要限制是缺乏I级和II级证据。
结论：原发性BP肿瘤的理想治疗策略是完全手术切除。然而,在某些情况下,特别是对于神经纤维瘤，STR可能是优选的以保持最大的神经功能。手术切除的程度（全部或部分）主要取决于肿瘤的病理特征和原发位置。
