Skubitz Keith M, D'Adamo David R
Department of Medicine, University of Minnesota Medical School and Masonic Cancer Center, Minneapolis, USA.
Mayo Clin Proc. 2007 Nov;82(11):1409-32. doi: 10.4065/82.11.1409.
Sarcomas comprise a heterogeneous group of mesenchymal neoplasms. They can be grouped into 2 general categories, soft tissue sarcoma and primary bone sarcoma, which have different staging and treatment approaches. This review includes a discussion of both soft tissue sarcomas (malignant fibrous histiocytoma, liposarcoma, leiomyosarcoma, synovial sarcoma, dermatofibrosarcoma protuberans, angiosarcoma, Kaposi sarcoma, gastrointestinal stromal tumor, aggressive fibromatosis or desmoid tumor, rhabdomyosarcoma, and primary alveolar soft-part sarcoma) and primary bone sarcomas (osteosarcoma, Ewing sarcoma, giant cell tumor, and chondrosarcoma). The 3 most important prognostic variables are grade, size, and location of the primary tumor. The approach to a patient with a sarcoma begins with a biopsy that obtains adequate tissue for diagnosis without interfering with subsequent optimal definitive surgery. Subsequent treatment depends on the specific type of sarcoma. Because sarcomas are relatively uncommon yet comprise a wide variety of different entities, evaluation by oncology teams who have expertise in the field is recommended. Treatment and follow-up guidelines have been published by the National Comprehensive Cancer Network (www.nccn.org).
肉瘤是一组异质性的间叶组织肿瘤。它们可分为两大类,即软组织肉瘤和原发性骨肉瘤,这两类肉瘤具有不同的分期和治疗方法。本综述包括对软组织肉瘤(恶性纤维组织细胞瘤、脂肪肉瘤、平滑肌肉瘤、滑膜肉瘤、隆突性皮肤纤维肉瘤、血管肉瘤、卡波西肉瘤、胃肠道间质瘤、侵袭性纤维瘤病或硬纤维瘤、横纹肌肉瘤以及原发性肺泡软组织肉瘤)和原发性骨肉瘤(骨肉瘤、尤因肉瘤、巨细胞瘤和软骨肉瘤)的讨论。3个最重要的预后变量是原发肿瘤的分级、大小和位置。对肉瘤患者的治疗始于活检,活检要获取足够的组织用于诊断,同时不干扰后续的最佳确定性手术。后续治疗取决于肉瘤的具体类型。由于肉瘤相对不常见,但包含多种不同的实体,建议由该领域的专业肿瘤学团队进行评估。美国国立综合癌症网络(www.nccn.org)已发布了治疗和随访指南。