Jager P L, Hoekstra H J, Leeuw J, van Der Graaf W T, de Vries E G, Piers D
Department of Nuclear Medicine, University Hospital Groningen, Groningen, The Netherlands.
Cancer. 2000 Oct 15;89(8):1726-31. doi: 10.1002/1097-0142(20001015)89:8<1726::aid-cncr12>3.0.co;2-v.
The incidence of bone metastases in soft tissue sarcoma (STS) patients seems to be low but has not been studied separately. In this study, the authors aimed to determine the value of routine radionuclide bone scanning in preoperative staging of STS patients.
Preoperative bone scans were evaluated retrospectively in 109 consecutive patients (median age, 44 years; range, 1-86) with intermediate or high grade STS. Scans were scored in 3 categories: 1, metastases very likely; 2, equivocal; and 3, normal or benign lesions.
Category 1 scans were found in 8 of 109 patients (7%); in all 8 patients, bone metastases were confirmed. Six of these eight patients reported pain, and all had additional lung, bone marrow, or lymph node metastases. The highest rate (17%) was found in the rhabdomyosarcoma subgroup (n = 18). Category 2 (equivocal) scans were present in 12 of 109 patients (11%), in all of which bone metastases were excluded through additional investigations. Category 3 (normal) scans were found in 81%. Bone metastases were at least as frequent as lung metastases (4%) and were the single site of systemic disease in 4%. The rate of bone metastases was 55% in patients with bone pain versus 2% in patients without pain.
Bone metastases in primary STS patients are rare (7%) yet in this study at least as frequent as lung metastases. The low rate in asymptomatic patients versus the high rate in symptomatic patients supports the use of bone scanning in symptomatic patients only. The yield of routine bone scanning is low.
软组织肉瘤（STS）患者发生骨转移的发生率似乎较低，但尚未单独进行研究。在本研究中，作者旨在确定常规放射性核素骨扫描在STS患者术前分期中的价值。
对109例连续的中、高级别STS患者（中位年龄44岁；范围1 - 86岁）的术前骨扫描进行回顾性评估。扫描结果分为3类：1类，很可能有转移；2类，不明确；3类，正常或良性病变。
109例患者中有8例（7%）扫描结果为1类；在这8例患者中，均确诊有骨转移。这8例患者中有6例报告有疼痛，且均有额外的肺、骨髓或淋巴结转移。横纹肌肉瘤亚组（n = 18）的发生率最高（17%）。109例患者中有12例（11%）扫描结果为2类（不明确），所有这些患者均通过进一步检查排除了骨转移。81%的患者扫描结果为3类（正常）。骨转移的发生率至少与肺转移（4%）一样高，且在4%的患者中是系统性疾病的唯一部位。有骨痛的患者骨转移发生率为55%，而无疼痛的患者为2%。
原发性STS患者的骨转移很少见（7%），但在本研究中其发生率至少与肺转移一样高。无症状患者发生率低而有症状患者发生率高，这支持仅对有症状的患者进行骨扫描。常规骨扫描的阳性率较低。
