目的:本研究的目的是回顾一系列胸部侵袭性纤维瘤病(AF)病例,重点是不同程度切除的结果和术后放疗的价值。
方法:回顾性分析1982-2014年我院收治的胸部房颤患者的临床资料。比较R0,R1和R2切除组之间的复发率和非疾病生存期(NDS)时间。
结果:在研究期间治疗了47例胸部房颤(21名男性,26名妇女),诊断时的平均年龄为40岁(范围,9-77岁)。一名病人在手术前死亡,46例患者共接受85次切除。41名患者有完整的随访数据,平均随访时间为125.6个月(范围,11-524个月)。复发率为6.7%,92.9%,R0、R1和R2切除组的100%,分别,R0复发率明显低于R1和R2(P值均<0.001)。R0,R1,R2组的NDS时间分别为80.3±64.8,23.6±38.7,9.8±10.8个月,R0组NDS时间明显长于R1、R2组(P值均<0.01)。在每种切除类型中,与接受手术和放疗的患者相比,仅接受手术的患者的复发率没有显着差异(所有P值>0.05)。
结论:R0切除是治疗胸部房颤最有效的方法。术后放疗未降低复发率。
OBJECTIVE: The purpose of the study was to review a large series of chest aggressive fibromatosis (AF) cases with an emphasis on the outcomes of different degrees of resection and the value of postoperative radiotherapy.
METHODS: The records of patients with chest AF treated at our hospital from 1982 to 2014 were retrospectively reviewed. Recurrence rates and non-disease survival (NDS) times were compared between the R0, R1, and R2 resection groups.
RESULTS: Forty-seven cases of chest AF were treated during the study period (21 men, 26 women), with an average age at diagnosis of 40 years (range, 9-77 years). One patient died before surgery, and 46 patients received a total of 85 resections. Forty-one patients had complete follow-up data, and the average follow-up time was 125.6 months (range, 11-524 months). Recurrence rates were 6.7%, 92.9%, and 100% for the R0, R1, and R2 resection groups, respectively, and the R0 recurrence rate was significantly lower than the R1 and R2 rates (both P values < 0.001). The NDS time of the R0, R1, and R2 groups was 80.3 ± 64.8, 23.6 ± 38.7, and 9.8 ± 10.8 months, respectively; the NDS time of the R0 group was significantly longer than that of the R1 and R2 groups (both P values < 0.01). Within each resection type, no significant differences were found in the recurrence rates of patients having surgery alone compared with those receiving surgery and radiotherapy (all P values > 0.05).
CONCLUSIONS: R0 resection is the most effective treatment for chest AF. Postoperative radiotherapy did not reduce the recurrence rate.