Patients with Kimura disease who present with one or more of the following high-risk features are at elevated risk of relapse after surgery alone and require a more intensive treatment approach:
Patients meeting any of these thresholds are more likely to experience disease relapse even following complete surgical resection. For this reason, surgery alone is generally insufficient, and adjuvant therapy is recommended to reinforce long-term disease control.
The recommended strategy combines surgical excision with adjuvant therapy. The adjuvant component may involve a form of radiation or systemic immunosuppressive treatment — the specific selection and full structured regimen are available in the complete protocol.
DOI: 10.1016/j.ijsu.2022.106591
Combination adjuvant therapy with surgery is recommended for the following conditions — a tumor greater than or equal to 3 cm in size, symptom duration longer than or equal to 5 years, peripheral blood eosinophilia greater than or equal to 20%, or serum IgE greater than or equal to 10000 IU/ml to achieve the optimal therapeutic outcome.
Adjuvant therapies with radiotherapy, systemic immunosuppressive medications, including oral corticosteroids, cyclosporine, mycophenolate mofetil, mycophenolic acid, leflunomide and methylprednisolone, and tacrolimus may facilitate the efficacy of treatment.
We found that the patients with a maximal tumor diameter ≥3 cm, disease duration ≥5 years, peripheral eosinophil counts ≥20% or serum IgE level ≥10000 IU/ml were more likely to suffer relapse even after surgery, then adjuvant therapy should intervene to reinforce the control of recurrence.
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