评估手术切除和重建在儿科胸壁尤文氏肉瘤治疗中的作用:一项系统综述。

IF 2 3区 医学 Q3 ONCOLOGY
Darragh Rice, Seán Barrett, Naomi Lavan, Patricia Daly, Cormac Owens, Jane Pears, Michael Capra, Jonathan McGuinness
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引用次数: 0

摘要

背景和目的:尤文氏肉瘤是儿科人群中最常见的恶性胸壁肿瘤。在新辅助化疗方案后,手术切除和胸壁重建的作用和程度仍不清楚。方法:根据PRISMA指南对四个主要文献数据库进行系统评价。提取有关总生存率、复发率、手术作用和辅助治疗作用的数据。结果:最初通过检索确定了391项研究,最终分析包括25项单中心观察性研究(458例患者)和10项多中心试验的回顾性评价(961例患者)。5年总生存率从35%到90%不等。讨论:与化疗一起,局部控制和手术切除是治疗儿童胸壁尤文氏肉瘤的基石。文献倾向于将手术推迟到新辅助化疗后,并且根据化疗前的边缘进行广泛切除的益处似乎有限,这是目前指南所提倡的。放疗不再被提倡用于所有患者,而应根据手术边缘和切除标本对化疗的组织学反应来指导。外科重建技术需要针对这些儿童患者的生长潜力进行定制,以避免长期的后遗症,包括脊柱侧凸和肺限制性疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluating the Role of Surgical Resection and Reconstruction in the Management of Ewing sarcoma of the Chest Wall in the Paediatric Population: A Systematic Review.

Background and objectives: Ewing sarcoma is the most common malignant chest wall tumour in the paediatric population. Following neoadjuvant chemotherapy regimens, the role and extent of surgical resection and reconstruction of the chest wall remain unclear.

Methods: A systematic review was conducted in accordance with PRISMA guidelines across four major literature databases. Data regarding overall survival, rate of recurrence, role of surgery and adjuvant therapy role was extracted.

Results: Three thousand ninety-one studies were initially identified via the search, with 25 single-centre observational studies (458 patients) and 10 retrospective reviews of multicentre trials (961 patients) included in the final analysis. Five-year overall survival ranged from 35% to 90%.

Discussion: Along with chemotherapy, local control with surgical resection provides the cornerstone of the management of Ewing sarcoma of the chest wall in children. The literature favours delaying surgery until after neoadjuvant chemotherapy, and there appear to be limited benefits to extensive resection according to pre-chemotherapy margins, advocated for in current guidelines. Radiotherapy is no longer advocated for all patients, but rather should be guided by surgical margins and the histological response to chemotherapy in the resected specimens. Surgical reconstructive techniques need to be tailored for the growth potential of these paediatric patients to avoid long-term sequalae, including scoliosis and pulmonary restrictive disease.

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来源期刊
CiteScore
4.70
自引率
4.00%
发文量
367
审稿时长
2 months
期刊介绍: The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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