目的:评估常规全身磁共振成像(WBMRI)监测对黏液样脂肪肉瘤患者的临床影响。
方法:这是一项回顾性队列研究,研究对象是2006年10月至2020年12月在我们机构接受至少一次WBMRI的黏液样脂肪肉瘤患者。WBMRI对临床管理的影响,即治疗修改或额外的诊断研究进行了研究。2015年制定了标准化的WBMRI监测协议。我们比较了接受和未接受常规WBMRI监测的转移性患者的患者预后,并对两个亚组进行了生存分析。
结果:在56例患者中(60.7%为男性,中位年龄:48.1岁)接受345WBMRI,17例(30.3%)有转移,该组进行了168例WBMRI。整个队列的中位影像学随访时间为35个月;转移组的中位随访时间为42个月。WBMRI改变了13例(76.5%)转移性患者的临床管理,33例治疗修改。35个病变被标记为不确定,\'16(45.7%)进行了额外的调查/干预,4例(11.4%)被证实为转移。最初在WBMRI上错过了21个转移灶,并在随后的WBMRI上得到证实。其中5例(23.8%)具有临床意义。在常规监测亚组中,自发现转移以来的5年生存率较好(85.7%vs.45%),但这没有统计学意义(p=0.068).5例患者(8.9%)在诊断出原发灶后超过5年发生了首次转移。
结论:对黏液样脂肪肉瘤患者进行定期WBMRI监测,经常影响治疗决策,从而极大地影响临床管理。
结论:WBMRI最近被推荐作为粘液样脂肪肉瘤患者分期和监测的成像选择。我们的研究强调了定期WBMRI监测对这些患者的临床管理的影响,以及它如何影响他们的生存。
OBJECTIVE: To assess the clinical impact of regular whole-body magnetic resonance imaging (WBMRI) surveillance in myxoid liposarcoma patients.
METHODS: This was a retrospective cohort study of myxoid liposarcoma patients who underwent at least one WBMRI at our institution between October 2006 and December 2020. The effect of WBMRI on clinical management, namely treatment modification or additional diagnostic investigations was studied. A standardised WBMRI surveillance protocol was instituted in 2015. We compared patient outcomes for the metastatic patients who had and had not received regular WBMRI surveillance and performed survival analysis for both subgroups.
RESULTS: Of the 56 patients (60.7% male, median age: 48.1 years) who underwent 345 WBMRI, 17 (30.3%) had metastases, and 168 WBMRI were performed in this group. The median imaging follow-up for the entire cohort was 35 months; the metastatic group had a median follow-up of 42 months. WBMRI changed the clinical management in 13 (76.5%) metastatic patients, with 33 instances of treatment modification. Thirty-five lesions were labelled \'indeterminate,\' 16 (45.7%) had additional investigations/interventions, and 4 (11.4%) were confirmed to be metastatic. Twenty-one metastatic lesions were missed initially on WBMRI and confirmed on subsequent WBMRI, of which 5 (23.8%) were clinically significant. The 5-year survival since the detection of metastasis was better in the regular surveillance subgroup (85.7% vs. 45%), but this was not statistically significant (p = 0.068). Five patients (8.9%) developed their first metastasis more than 5 years after diagnosing the primary lesion.
CONCLUSIONS: Regular WBMRI surveillance of myxoid liposarcoma patients considerably impacts clinical management by frequently influencing treatment decisions.
CONCLUSIONS: WBMRI has been recently recommended as an imaging option for the staging and surveillance of myxoid liposarcoma patients. Our study highlights the impact of regular WBMRI surveillance on the clinical management of these patients and how it affects their survival.