Kawai Akira, Hasizume Hiroyuki, Sugihara Shinsuke, Morimoto Yuki, Inoue Hajime
Department of Orthopaedic Surgery, Okayama University Medical School, Japan.
Int Orthop. 2002;26(1):26-30. doi: 10.1007/s002640100297.
We studied 13 consecutive patients with bone and soft tissue sarcomas of the hand and wrist. Chondrosarcoma, Ewing's sarcoma, synovial sarcoma and epithelioid sarcoma were the most frequent histological diagnoses. Limb-sparing surgery was performed in ten patients but eventually three patients required an amputation. Surgical margins were wide in nine patients and marginal in four. Adjuvant therapy for nine patients consisted of chemotherapy in five and chemotherapy with radiation in four. Local recurrence occurred in two patients with epithelioid sarcoma. There was no significant relationship between surgical margin and local recurrence. Distant metastasis occurred in four patients. The 5-year survival rate was 66%. The mean functional score was 87%. Our study indicates that treatment consisting of resection of these tumours with either a wide margin or a marginal margin followed by adjuvant radiation appeared to be safe and resulted in an acceptable degree of limb function except in the patients with epithelioid sarcoma.
我们研究了13例连续性手部和腕部骨肉瘤及软组织肉瘤患者。软骨肉瘤、尤因肉瘤、滑膜肉瘤和上皮样肉瘤是最常见的组织学诊断类型。10例患者接受了保肢手术，但最终有3例患者需要截肢。9例患者手术切缘为广泛切除，4例为边缘切除。9例患者的辅助治疗包括5例化疗和4例化疗联合放疗。2例上皮样肉瘤患者发生局部复发。手术切缘与局部复发之间无显著相关性。4例患者发生远处转移。5年生存率为66%。平均功能评分为87%。我们的研究表明，对这些肿瘤进行广泛或边缘切除后再进行辅助放疗的治疗方法似乎是安全的，除上皮样肉瘤患者外，肢体功能恢复程度尚可。
