骨盆原发性恶性骨肿瘤切除术后持续达到 R0 骨边缘的患者特定指南。

IF 2.5 3区 医学 Q3 ONCOLOGY
Xavier du Cluzel de Remaurin, Valerie Dumaine, Victoire Cladiere-Nassif, Philippe Anract, David Biau
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引用次数: 0

摘要

目的:骨盆原发性恶性骨肿瘤是一种不常见的病变,由于其三维解剖结构,通过徒手截骨术进行切除可能存在误差。患者特异性指南(Patient-Specific Guides,PSG),也称为患者特异性器械(Patient-Specific Instruments,PSI)对于确保手术规划和切除的充分性至关重要。我们的目的是评估其使用情况和效果:我们对 42 名接受基于 PSG 的骨盆原发性恶性骨肿瘤切除术的成年患者进行了单中心回顾性研究。主要结果是R0骨边缘的比例。次要结果是整体 R0 边缘的比例(考虑软组织切除)、局部复发的累积发生率以及导板的制作时间。在组织学边缘方面,与本机构之前的一个系列进行了比较:结果:使用 PSG 达到了 100% 的 R0 安全骨边缘,由于软组织切除被污染,总体 R0 边缘达到了 88%,而与之前的系列对比显示 R0 安全骨边缘仅为 80%。一年后局部复发的累积发生率为10%(95% CI:4-20%),两年后为15%(95% CI:6-27%),五年后为19%(95% CI:8-33%)。从首次联系到手术日期,指南制作过程的总持续时间中位数为 35 天(Q1-Q3:26-47 天):患者专用导板可提供可重复的安全骨边缘。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient-specific guides for consistently achieving R0 bone margins after resection of primary malignant bone tumors of the pelvis.

Aims: Primary malignant bone tumor of the pelvis is an uncommon lesion, the resection of which via freehand osteotomy is subject to inaccuracy due to its three-dimensional anatomy. Patient-Specific Guides (PSG), also called Patient-Specific Instruments (PSI) are essential to ensure surgical planning and resection adequacy. Our aim was to assess their use and effectiveness.

Methods: A monocentric retrospective study was conducted on 42 adult patients who underwent PSG-based resection of a primary malignant bone tumor of the pelvis. The primary outcome was the proportion of R0 bone margins. The secondary outcomes were the proportion of overall R0 margins, considering soft-tissue resection, the cumulative incidence of local recurrence, and the time of production for the guides. A comparison to a previous series at our institution was performed regarding histological margins.

Results: Using PSGs, 100% R0 safe bone margin was achieved, and 88% overall R0 margin due to soft-tissue resection being contaminated, while the comparison to the previous series showed only 80% of R0 safe bone margin. The cumulative incidences of local recurrence were 10% (95% CI: 4-20%) at one year, 15% (95% CI: 6-27%) at two years, and 19% (95% CI: 8-33%) at five years. The median overall duration of the fabrication process of the guide was 35 days (Q1-Q3: 26-47) from the first contact to the surgery date.

Conclusions: Patient-Specific Guides can provide a reproducible safe bony margin.

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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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