Kim John Y, Youssef Adel, Subramanian Vairavan, Rogers Bruce A, Pollock Raphael E, Robb Geoffrey L, Chang David W
Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 443, Houston, TX 77030, USA.
Ann Surg Oncol. 2004 Oct;11(10):921-7. doi: 10.1245/ASO.2004.06.026.
Treatment for soft tissue sarcoma of the upper extremity has evolved to include limb salvage techniques. We reviewed our experience with limb salvage therapy for upper extremity sarcomas with an emphasis on functional outcomes following the reconstructive surgery.
A retrospective analysis was performed of 81 consecutive patients with soft tissue sarcoma of the upper extremity who had limb salvage therapy with reconstruction by a plastic surgeon. Univariate and multivariate regression analyses of relevant outcome variables were performed. Enneking functional scores were obtained from 43 patients.
The study included 16 microvascular reconstructions and 67 non-microvascular reconstructions for a total of 83 reconstructions in 81 patients. The mean defect size was 129 cm(2) (standard deviation: 106 cm(2)). The mean total functional score was 23.1 (range, 9 to 30). Any reconstruction-related complication and preoperative chemotherapy use were associated with a 7.3 point (P = .03) and 4.7 point (P = .01) decrease in total functional score, respectively. Kaplan-Meier product-limit analysis showed 82% 5-year overall survival and 67% 5-year disease-free survival rates.
For soft tissue sarcoma of the upper extremity, limb salvage with good functional outcome is possible with a judicious approach to reconstruction.
上肢软组织肉瘤的治疗已发展为包括保肢技术。我们回顾了我们在上肢肉瘤保肢治疗方面的经验，重点关注重建手术后的功能结果。
对81例接受整形外科医生重建的上肢软组织肉瘤患者进行回顾性分析。对相关结果变量进行单因素和多因素回归分析。从43例患者中获得Enneking功能评分。
该研究包括16例微血管重建和67例非微血管重建，81例患者共进行了83次重建。平均缺损面积为129平方厘米（标准差：106平方厘米）。平均总功能评分为23.1（范围9至30）。任何与重建相关的并发症和术前化疗的使用分别使总功能评分降低7.3分（P = 0.03）和4.7分（P = 0.01）。Kaplan-Meier乘积限分析显示5年总生存率为82%，5年无病生存率为67%。
对于上肢软组织肉瘤，通过明智的重建方法可以实现功能良好的保肢。
