Wilson R B, Crowe P J, Fisher R, Hook C, Donnellan M J
Department of Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Aust N Z J Surg. 1999 May;69(5):344-9. doi: 10.1046/j.1440-1622.1999.01569.x.
To identify risk factors for local recurrence and overall survival in patients with extremity soft tissue sarcoma.
A retrospective study was performed of all patients with extremity soft tissue sarcoma treated at the Combined Surgical Oncology Clinic in the Institute of Oncology at Prince of Wales Hospital between 1972 and 1992. Variables analysed included clinical presentation, patient characteristics, tumour characteristics, treatment factors and outcome.
One hundred and nineteen patients were eligible for the study. The most common type of presentation was with a painless mass, usually in the thigh. Local control rates at 5 and 10 years were 75% and 73%. Local control was higher in patients who had more radical surgery and in those who received adjuvant radiotherapy. Tumour size and high grade were independent risk factors for poorer survival. Patients over 50 had poorer survival than younger patients and those who presented with recurrent tumours also tended to have poor survival compared to patients presenting de novo. The respective 5- and 10-year survival rates were 65% and 62%.
This study suggests that local control of extremity soft tissue sarcoma is improved by radical surgery and by the addition of radiotherapy when more conservative procedures are used. Overall survival appeared to be largely determined by patient (age, recurrent presentation) and tumour characteristics (grade, size).
确定肢体软组织肉瘤患者局部复发和总生存的危险因素。
对1972年至1992年间在威尔士亲王医院肿瘤研究所联合外科肿瘤门诊接受治疗的所有肢体软组织肉瘤患者进行回顾性研究。分析的变量包括临床表现、患者特征、肿瘤特征、治疗因素和结局。
119例患者符合研究条件。最常见的表现形式是无痛性肿块，通常位于大腿。5年和10年的局部控制率分别为75%和73%。接受更根治性手术的患者以及接受辅助放疗的患者局部控制情况更好。肿瘤大小和高级别是生存较差的独立危险因素。50岁以上患者的生存情况比年轻患者差，与初发患者相比，复发肿瘤患者的生存情况也往往较差。5年和10年生存率分别为65%和62%。
本研究表明，当采用更保守的手术方式时，根治性手术和加用放疗可改善肢体软组织肉瘤的局部控制。总生存似乎很大程度上由患者（年龄、复发表现）和肿瘤特征（分级、大小）决定。
