Kaytan Esra, Yaman Fulya, Cosar Rusen, Eralp Yesim, Saip Pnar, Darendeliler Emin
Department of Radiation Oncology, University of Istanbul, Institute of Oncology, Istanbul, Turkey.
Am J Clin Oncol. 2003 Aug;26(4):411-5. doi: 10.1097/01.COC.0000027461.17853.74.
The prognostic factors associated with local failure and overall survival and the effect of radiotherapy were determined in 77 patients with localized (extremity and nonextremity) operable soft-tissue sarcoma. There were 52 male and 25 female patients; median age was 50 years (range: 15-83). Histologic grade of the tumors was as follows: low-intermediate grade in 32 cases and high grade in 29 cases. The primary tumors were treated by marginal resection (20 patients), wide resection (52 patients), and radical resection (5 patients). Adjuvant radiotherapy was applied to 50 (65%) patients. The 5-year local recurrence-free survival rate was 70.6%. Treatment with adjuvant radiotherapy and development of metastases were the significant prognostic factors associated with local recurrence. Radiotherapy was more effective in patients with tumors 10 cm or larger, marginally resected, extremity located, and high grades. The overall survival rate was 64.4% at 5 years. Significant adverse prognostic factors were high grade tumors, presence of local recurrence, and development of metastases in univariate analyses. Development of metastases and old age were the only adverse prognostic factors by multivariate analysis. The best 5-year survival rate was obtained in female patients younger than 50 years (90%). The present study demonstrated the importance of adjuvant radiotherapy and development of metastases as prognostic factors for local control. Again, development of metastases and age were the most important prognostic factors in operable soft-tissue sarcomas.
在77例局限性（肢体和非肢体）可手术切除的软组织肉瘤患者中，确定了与局部复发和总生存相关的预后因素以及放疗的效果。患者中男性52例，女性25例；中位年龄为50岁（范围：15 - 83岁）。肿瘤的组织学分级如下：低 - 中级32例，高级29例。原发肿瘤采用边缘切除（20例患者）、广泛切除（52例患者）和根治性切除（5例患者）进行治疗。50例（65%）患者接受了辅助放疗。5年局部无复发生存率为70.6%。辅助放疗和转移的发生是与局部复发相关的重要预后因素。放疗对肿瘤直径10 cm或更大、边缘切除、位于肢体且分级高的患者更有效。5年总生存率为64.4%。单因素分析中，重要的不良预后因素是高级别肿瘤、局部复发的存在和转移的发生。多因素分析中，转移的发生和老年是唯一的不良预后因素。年龄小于50岁的女性患者5年生存率最佳（90%）。本研究证明了辅助放疗和转移的发生作为局部控制预后因素的重要性。同样，转移的发生和年龄是可手术切除软组织肉瘤最重要的预后因素。
