Ahlmann Elke R, Falkinstein Yuri, Fedenko Alexander N, Menendez Lawrence R
Department of Orthopaedics, Los Angeles County University of Southern California Medical Center, Los Angeles, CA 90033, USA.
Clin Orthop Relat Res. 2007 Jun;459:174-81. doi: 10.1097/BLO.0b013e318059b898.
Cryosurgical ablation has been used successfully for treating various carcinomas and bone tumors; however, few studies report the use of cryosurgery followed by tumor resection for the treatment of soft tissue sarcomas. We evaluated local recurrence, progression of disease, histologic necrosis from the cryoablation, complications, patient survival, and functional outcomes using this approach. We retrospectively reviewed 38 patients with no prior treatment for their neoplasm who underwent cryosurgery followed by wide excision of soft tissue sarcomas. Three patients developed local recurrence. Sixteen patients had evidence of more than 95% tumor necrosis, and 11 of these had 100% histologic necrosis. We observed a difference in overall survival and disease-free survival based on the adequacy of freezing process. Patients with more than 95% necrosis had a survival rate of 94% at 2 years and 86% at 5 years, while those with less than 95% necrosis survived 53% at 2 years and 34% at 5 years. Complications included transient neuropraxia (13%), superficial wound infections (8%), and seroma (21%). Cryosurgical ablation appears a safe and effective method of devitalizing tumor cells of soft tissue sarcomas.
冷冻消融术已成功用于治疗各种癌症和骨肿瘤；然而，很少有研究报道采用冷冻手术联合肿瘤切除治疗软组织肉瘤。我们评估了采用这种方法后的局部复发、疾病进展、冷冻消融后的组织学坏死、并发症、患者生存率和功能结果。我们回顾性分析了38例未经肿瘤前期治疗的患者，这些患者接受了冷冻手术，随后对软组织肉瘤进行了广泛切除。3例患者出现局部复发。16例患者有超过95%的肿瘤坏死证据，其中11例有100%的组织学坏死。基于冷冻过程的充分性，我们观察到总生存率和无病生存率存在差异。坏死超过95%的患者2年生存率为94%，5年生存率为86%，而坏死低于95%的患者2年生存率为53%，5年生存率为34%。并发症包括短暂性神经失用（13%）、浅表伤口感染（8%）和血清肿（21%）。冷冻消融术似乎是一种使软组织肉瘤肿瘤细胞失活的安全有效的方法。
