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成人四肢与躯干软组织肉瘤。124例报告。

Soft tissue sarcomas of the extremities and trunk in the adult. Report of 124 cases.

作者信息

Zornig C, Weh H J, Krüll A, Schwarz R, Hilgert R E, Schröder S

机构信息

Abteilung für Allgemeinchirurgie, Universitätsklinik, Hamburg, BRD.

出版信息

Langenbecks Arch Chir. 1992;377(1):28-33. doi: 10.1007/BF00186146.

Abstract

Between 1970 and 1988 surgery was performed on 124 patients with soft tissue sarcomas of the extremities and trunk in the University Clinics of Hamburg. Liposarcoma, malignant fibrous histiocytoma, fibrosarcoma and malignant schwannoma were the most common histological types. High-grade sarcomas (G3) predominated, with 41%, while 26% were graded G2 and 33% G1. Resection with wide margins all round was achieved in only 54% of the patients. The quality of the operation proved to be only therapy-related prognostic factor. In addition, tumour grade, size, regional lymph node and distant metastasis and histological type proved to be relevant to the prognosis. With multivariate analysis, distant metastasis, grade, resectability and histological type retained prognostic significance. The efficacy of adjuvant chemo- and radiotherapy was related to the quality of the preceding tumour resection. In case of gross tumour the rate of either partial or complete response was 28% for chemotherapy and 22% for radiotherapy. The mean survival time was 102 months; the 5- and 10-year survival rates were 48% and 37%, respectively.

摘要

1970年至1988年间,汉堡大学诊所对124例四肢和躯干软组织肉瘤患者实施了手术。脂肪肉瘤、恶性纤维组织细胞瘤、纤维肉瘤和恶性神经鞘瘤是最常见的组织学类型。高级别肉瘤(G3)占主导,为41%,而G2级占26%,G1级占33%。仅54%的患者实现了四周切缘阴性的切除。手术质量被证明是唯一与治疗相关的预后因素。此外,肿瘤分级、大小、区域淋巴结及远处转移和组织学类型被证明与预后相关。多因素分析显示,远处转移、分级、可切除性和组织学类型仍具有预后意义。辅助化疗和放疗的疗效与之前肿瘤切除的质量相关。对于大体肿瘤,化疗的部分或完全缓解率为28%,放疗为22%。平均生存时间为102个月;5年和10年生存率分别为48%和37%。

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