Gerrand C H, Wunder J S, Kandel R A, O'Sullivan B, Catton C N, Bell R S, Griffin A M, Davis A M
University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada.
Ann Surg Oncol. 2004 May;11(5):476-82. doi: 10.1245/ASO.2004.07.016. Epub 2004 Apr 12.
The purpose of this study was to explore the relationship between the anatomical location of lower-extremity soft-tissue sarcoma and functional outcome.
Function was evaluated with the Musculoskeletal Tumor Society (MSTS 1993) score and Toronto Extremity Salvage Score (TESS); 207 patients (median age, 54 years) were eligible. The median maximum tumor diameter was 8.0 cm; 58 tumors were superficial and 149 were deep. Nine locations based on anatomical compartments were defined: 6 tumors were in the groin/femoral triangle; 8, the buttock; 52, the anterior thigh; 22, the medial thigh; 20, the posterior thigh; 10, the popliteal fossa; 13, the posterior calf; 11, the anterolateral leg; and 7, the foot or ankle.
Treatment of superficial tumors did not lead to significant changes in MSTS score (mean, 90.6% preoperatively vs. 93.0% postoperatively; P =.566) or TESS (mean, 86.4% preoperatively vs. 90.9% postoperatively; P =.059). Treatment of deep tumors lead to significant reductions in MSTS score and TESS (mean MSTS, 86.9% preoperatively vs. 83.0% postoperatively; P =.001; and mean TESS, 83.0% preoperatively vs. 79.4% postoperatively; P =.015). Anatomical location was not a significant predictor of aggregated MSTS and TESS evaluations. Exploratory analysis showed variation in MSTS pain and gait handicap or limp items and TESS dressing, sitting, bending, and bathing items by anatomical location.
The treatment of superficial tumors does not lead to significant changes in MSTS score or TESS. Anatomical location is not a significant predictor of aggregated MSTS and TESS evaluations. However, there is variation in MSTS and TESS item scores across anatomical locations.
本研究旨在探讨下肢软组织肉瘤的解剖位置与功能结局之间的关系。
采用肌肉骨骼肿瘤学会（MSTS 1993）评分和多伦多肢体挽救评分（TESS）评估功能；207例患者（中位年龄54岁）符合条件。肿瘤最大直径中位数为8.0 cm；58例肿瘤为浅表性，149例为深部。根据解剖分区定义了9个部位：6例肿瘤位于腹股沟/股三角；8例位于臀部；52例位于大腿前部；22例位于大腿内侧；20例位于大腿后部；10例位于腘窝；13例位于小腿后部；11例位于小腿前外侧；7例位于足部或踝部。
浅表肿瘤的治疗未导致MSTS评分（术前平均90.6%，术后93.0%；P = 0.566）或TESS（术前平均86.4%，术后90.9%；P = 0.059）出现显著变化。深部肿瘤的治疗导致MSTS评分和TESS显著降低（MSTS平均术前86.9%，术后83.0%；P = 0.001；TESS平均术前83.0%，术后79.4%；P = 0.015）。解剖位置不是MSTS和TESS综合评估的显著预测因素。探索性分析显示，MSTS疼痛和步态障碍或跛行项目以及TESS穿衣、坐姿、弯腰和沐浴项目因解剖位置而异。
浅表肿瘤的治疗不会导致MSTS评分或TESS出现显著变化。解剖位置不是MSTS和TESS综合评估的显著预测因素。然而，MSTS和TESS项目评分在不同解剖位置存在差异。
