Neuropathic Pain Following Surgery for Malignant Peripheral Nerve Sheath Tumors

被引：1

作者：

Raasveld, Floris V. ^{[1
,2
,3
]}

Hanna, Tareq ^{[2
]}

Pacheco, Fernando J. ^{[2
]}

Gonzalez, Marcos R. ^{[4
]}

Johnston, Benjamin ^{[5
]}

Lozano-Calderon, Santiago A. ^{[4
]}

Valerio, Ian L. ^{[1
]}

Eberlin, Kyle R. ^{[1
]}

机构：

[1] Harvard Univ, Massachusetts Gen Hosp, Dept Gen Surg, Div Plast & Reconstruct Surg, Boston, MA 02114 USA

[2] Harvard Med Sch, Massachusetts Gen Hosp, Hand & Arm Ctr, Dept Orthoped Surg, Boston, MA USA

[3] Erasmus Univ, Erasmus Med Ctr, Dept Plast Reconstruct & Hand Surg, Rotterdam, Netherlands

[4] Harvard Med Sch, Massachusetts Gen Hosp, Dept Orthoped Surg, Boston, MA USA

[5] Harvard Med Sch, Dept Neurosurg, Brigham & Womens Hosp, Boston, MA USA

来源：

ANNALS OF SURGICAL ONCOLOGY | 2025年

关键词：

Malignant peripheral nerve sheath tumor; Neuropathic pain; Survival; En bloc excision; Targeted muscle reinnervation; SURVIVAL;

D O I：

10.1245/s10434-025-17001-9

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundMalignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas that pose significant challenges in surgical management. This study aims to examine the anatomic distribution of MPNSTs, analyze survival rates and predictive factors for survival, and investigate the prevalence of neuropathic pain in patients who have undergone MPNST resection.Patients and MethodsA retrospective analysis of 119 patients who underwent MPNST resection was conducted. Additionally, a cross-sectional survey was administered and completed by 39 surviving patients to assess neuropathic pain prevalence using the NRS (0-10 scale) and the s-DN4 questionnaire, and quality of life (QoL) using the EQ-5D-5L index (0-1 scale).ResultsMPNSTs most commonly occurred in the lower extremity (42.9%), followed by the upper extremity (21.0%), trunk (19.3%), head and neck (11.8%), and pelvis (5.0%). Female sex (OR: 0.25, 95% CI: 0.10-0.61) and absence of metastases (OR: 0.15, 95% CI: 0.05-0.52) were significantly associated with lower odds of mortality. Among survey respondents, 82.1% reported neuropathic pain following MPNST resection. The patients reported a mean EQ-5D-5L index score of 0.566 (+/- 0.253) as compared with an EQ-5D-5L of 0.851 (+/- 0.205) for the US general population.ConclusionsThe high prevalence of neuropathic pain following MPNST resection and its significant impact on QoL highlights the need for improved pain management strategies. Nerve-sparing and/or nerve-reconstructive techniques during or after tumor resection should be considered. Future research should focus on identifying risk factors for neuropathic pain development and evaluating the efficacy of preventive measures to improve long-term pain outcomes for surviving patients with MPNST.

引用

页码：3741 / 3751

页数：11

共 37 条

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