Donati D, El Ghoneimy A, Bertoni F, Di Bella C, Mercuri M
Orthopaedic Division, Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy.
J Bone Joint Surg Br. 2005 Nov;87(11):1527-30. doi: 10.1302/0301-620X.87B11.16621.
We reviewed 124 patients with a conventional pelvic chondrosarcoma who had been treated over a period of 20 years. We recorded the type of tumour (central or peripheral), type of operation (limb salvage surgery or hemipelvectomy), the grade of tumour, local recurrence and/or metastases, in order to identify the factors which might influence survival. More satisfactory surgical margins were achieved for central tumours or in those patients treated by hemipelvectomy. However, grade 1 tumours, whatever the course, did not develop metastases or cause death, while grade 3 tumours had the worst outcome and prognosis. Central, high-grade tumours require aggressive surgical treatment in order to achieve adequate surgical margins, particularly in those lesions located close to the sacroiliac joint. By contrast, grade 1 peripheral chondrosarcomas may be treated with contaminated margins in order to reduce operative morbidity, but without reducing survival.
我们回顾了124例接受传统骨盆软骨肉瘤治疗的患者,治疗时间跨度为20年。我们记录了肿瘤类型(中央型或周围型)、手术类型(保肢手术或半骨盆切除术)、肿瘤分级、局部复发和/或转移情况,以便确定可能影响生存的因素。中央型肿瘤或接受半骨盆切除术的患者获得了更满意的手术切缘。然而,1级肿瘤无论病程如何,均未发生转移或导致死亡,而3级肿瘤的结局和预后最差。中央型高级别肿瘤需要积极的手术治疗以获得足够的手术切缘,特别是对于那些位于骶髂关节附近的病变。相比之下,1级周围型软骨肉瘤可以在切缘受污染的情况下进行治疗,以降低手术并发症,但不影响生存率。