Rechl H, Wörtler K, Weirich G, Specht K, Gradinger R
Klinik für Orthopädie und Sportorthopädie, TU München.
MMW Fortschr Med. 2006 Apr 27;148(17):26, 28-30.
On account of the considerable variability of the clinical situation, treatment of soft tissue sarcoma requires an individually oriented multimodal approach. In the case of patients with superficial low-grade tumors measuring less than 5 cm in diameter, resection alone is usually adequate. In the event of medium-grade lesions, resection with negative margins, resection in combination with radiotherapy achieves excellent local control rates associated with an overall survival rate of almost 80%. In patients with high-grade sarcomas measuring more than 5 cm in diameter, local control can be achieved with resection and radiotherapy, although every second such patient develops metastases. For patients with local recurrence, further resection should be considered/performed. Radiotherapy is all the more effective, the smaller the postoperative tumor cell burden.
由于临床情况差异很大，软组织肉瘤的治疗需要采用个体化的多模式方法。对于直径小于5厘米的浅表低度肿瘤患者，通常仅行切除术就足够了。对于中度病变患者，切缘阴性的切除术、联合放疗的切除术可实现出色的局部控制率，总生存率近80%。对于直径大于5厘米的高度肉瘤患者，切除和放疗可实现局部控制，尽管每两名此类患者中就有一名会发生转移。对于局部复发的患者，应考虑/进行进一步切除。术后肿瘤细胞负荷越小，放疗就越有效。
