A Novel Method to Treat Progressive Desmoid Tumors Involving Neurovascular Bundles: A Retrospective Cohort Study.
Neurosurgery
; 88(6): 1095-1102, 2021 05 13.
Article
en En
| MEDLINE
| ID: mdl-33556169
ABSTRACT
BACKGROUND:
More effective therapies are needed to treat progressive desmoid tumors when active surveillance and systemic therapy fail.OBJECTIVE:
To assess the efficacy and safety of sandwich isolation surgery on the local control of progressive desmoid tumors involving neurovascular bundles.METHODS:
A total of 27 patients with progressive desmoid tumors at extremities involving neurovascular bundles who received surgery at our hospital between August 2014 and August 2018 were identified. A total of 13 patients received sandwich isolation surgery, in which R2 resection was performed in neurovasculature-involving regions, and a biomaterial patch was used to envelop involved neurovascular structures and isolate residual tumors. In non-neurovasculature-involving regions, wide resection was performed without isolation. A total of 14 patients received traditional surgery, which included tumor resection without isolation procedure.RESULTS:
In sandwich isolation group, tumor progressions and local recurrences occurred in 3 patients outside the isolated neurovasculature-involving regions. However, no progressions or recurrences occurred in any patients in the isolated neurovasculature-involving regions where R2 resection was performed. Sandwich isolation surgery group and traditional surgery group shared similar baseline clinical characteristics. The estimated 3-yr event-free survival rate was 76.9% after sandwich isolation surgery, and 32.7% after traditional surgery (P = .025). Patients who received sandwich isolation surgery were less likely to have local recurrence (hazard ratio 0.257, P = .040). No complications were noted except intermittent mild pain in operative regions (2 cases).CONCLUSION:
Sandwich isolation surgery is effective and safe for local control of desmoid tumors involving neurovascular bundles.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Fibromatosis Agresiva
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Neoplasia Residual
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Procedimientos de Cirugía Plástica
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Recurrencia Local de Neoplasia
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
Límite:
Adolescent
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Adult
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurosurgery
Año:
2021
Tipo del documento:
Article
País de afiliación:
China