Temple H T, Worman D S, Mnaymneh W A
Department of Orthopaedics and Rehabilitation, Orthopaedic Oncology Division, University of Miami School of Medicine, FL 33101, USA. htemple@ med.miami.edu
Cancer Control. 2001 May-Jun;8(3):262-8. doi: 10.1177/107327480100800306.
Soft-tissue tumors of the foot and ankle are relatively common and mostly benign. Thus, many malignant tumors in this region are improperly treated initially. Unplanned excisions can lead to complications that may adversely affect patient outcomes and prognosis.
A retrospective review of patients treated at our institute over a 20-year period for malignant soft-tissue tumors of the foot and ankle was performed. The effect of unplanned surgical excisions on outcomes was examined.
When limb salvage was attempted, patients who underwent unplanned surgical excisions had more complications and more extensive surgical procedures involving free flaps, and they were more likely to require adjuvant radiotherapy. No difference in recurrence and disease-free survival was evident between the two patient populations.
Despite the lack of statistical power to demonstrate differences in recurrence and survival, unplanned surgical excisions of soft-tissue sarcomas of the foot and ankle probably adversely affect quality of patient care. Suspicious lesions should be referred to surgeons trained in oncologic principles for evaluation and treatment.
足踝部软组织肿瘤相对常见,且大多为良性。因此,该区域的许多恶性肿瘤最初都未得到恰当治疗。计划外切除可能导致并发症,进而对患者的治疗效果和预后产生不利影响。
对我院20年间治疗的足踝部恶性软组织肿瘤患者进行回顾性研究。研究了计划外手术切除对治疗效果的影响。
在尝试保肢治疗时,接受计划外手术切除的患者出现更多并发症,且更多地需要进行涉及游离皮瓣的广泛手术,同时更有可能需要辅助放疗。两组患者在复发率和无病生存率方面无明显差异。
尽管缺乏统计学证据来证明复发率和生存率的差异,但足踝部软组织肉瘤的计划外手术切除可能会对患者的医疗质量产生不利影响。可疑病变应转诊给接受过肿瘤学原则培训的外科医生进行评估和治疗。