摘要
目的 探讨小儿恶性肿瘤术后复发或转移的影响因素和治疗。方法 回顾性分析1 999年 1月~ 2 0 0 2年 6月间收治的 41例 1 1个月~ 1 5岁的小儿恶性肿瘤术后复发或转移病例 ,其中1岁以下 2例、1~ 3岁 8例、4~ 6岁 1 1例、7~ 9岁 7例、1 0岁以上 1 3例。病理类型为神经母细胞瘤1 2例、软组织肉瘤 1 0例 (横纹肌肉瘤 7例、纤维肉瘤 3例 )、肾母细胞瘤 7例、生殖细胞恶性肿瘤 4例(骶尾部恶性畸胎瘤 2例、卵巢内胚窦瘤 1例 )、肝脏恶性肿瘤 3例 (肝脏肉瘤 2例、肝母细胞瘤 1例 )、其他恶性肿瘤 5例 (肾癌 2例、甲状腺癌、眼眶未分化癌、上肢恶性神经鞘瘤各 1例 )。首次手术时的临床分期为Ⅰ期 4例、Ⅱ期 1 2例、Ⅲ期 1 1例和Ⅳ期 1 4例。报道术后复发或转移的治疗及结果。结果 无论直接手术、再次手术或化疗后肿瘤根治术 ,至 2 0 0 2年 9月随访结果 ,存活率均达 80 %以上 ,以CT、B超及临床检查均无复发或转移为无瘤生存标准。原位复发 2 4例 (58.5 % ) ,术后远处转移 1 7例。首次手术肿瘤残留、肿瘤病理类型是术后复发或转移的主要影响因素。 2 2例 (53 .6 % )接受再次肿瘤根治术 ,存活率 80 % ,平均生存 (31 .6± 1 7.8)个月。 1 3例予化疗 ,至今无瘤生存 2 1例 (56 .8% ) ,平均生存时间 (2 3 .45±
Objective To sum up factors influencing recurrence and metastasis of pediatric solid tumor s. Methods Forty-one patients with recurrent or metastatic malignant solid tumors admitted between January 1999 and June 2002 were reviewed . They were 11 to 15 months of age. Two patients were under one year of age, 8 c ases between 1~3 years of age, 11 between 4~6 years, 7 between 7~9 years and 13 above 10 years. Twelve were diagnosed as neuroblastoma, 10 were soft tissue s arcomas (rhabdomyosarcoma 7, fibrosarcomas 3), 7 nephroblastomas, 4 germ cell t umors (sacral malignant teratomas 2, ovarian endodermal sinus tumor 1), maglin ant hepatoblastoma 1, hepatic sarcomas 2 and 5 other tumors (renal cell carcinomas 2, thyroid carcinoma 1, undifferentiated orbital tumor 1 and upper limb malignant Schwannoma 1). Twelve cases were belonged to stage II, 11 to stage III and 14 to stage IV on admission. Results Regardless of the treatment methodology, more tha n 80% of patients survived in these group. There were 24 cases with local recurr ence (58.5%) and 17 cases with distal metastasis. Twenty-two patients had re- do radical operation with survival rate of 80%. The mean survival duration was 31.6 ± 17.8 months. The mean survival duration of 13 patients who receive d chemotherapy was 23.45 ± 17.8 months. Conclusion With preoperative chemotherapy and re-do radi cal resection, recurrence or metastasis of pediatric solid malignant tumor is still amenable to satisfactory management.
出处
《中华小儿外科杂志》
CSCD
北大核心
2003年第4期301-303,共3页
Chinese Journal of Pediatric Surgery