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肩胛骨软骨肉瘤的肿瘤学及功能预后

Oncologic and functional outcome of scapular chondrosarcoma.

作者信息

Griffin Anthony M, Shaheen Mahmood, Bell Robert S, Wunder Jay S, Ferguson Peter C

机构信息

University Musculoskeletal Oncology Unit at Mount Sinai Hospital, The University of Toronto, Suite 476G, 600 University Avenue, Toronto, Canada.

出版信息

Ann Surg Oncol. 2008 Aug;15(8):2250-6. doi: 10.1245/s10434-008-9975-1. Epub 2008 May 28.

Abstract

BACKGROUND

The scapula is a common site for chondrosarcoma to occur. There has been disagreement between recent studies documenting the oncologic outcomes in patients with chondrosarcoma of the scapula. The purpose of this study was to investigate both the oncologic and functional outcomes of patients presenting to a large oncology center with primary chondrosarcoma of the scapula.

METHODS

A review of our prospectively collected database was carried out. All patients in the years 1989 to 2004 undergoing surgical resection of primary chondrosarcoma of the scapula were included. We documented patient demographics, whether the patient underwent partial or total scapulectomy, oncologic outcomes including local and systemic recurrence, and functional outcome using the Musculoskeletal Tumor Society (MSTS) 87, MSTS 93, and Toronto Extremity Salvage Score (TESS) rating systems.

RESULTS

Twenty-four patients (16 males, 8 females), with a mean age of 44 years (range 18-74 years), met the inclusion criteria. There were no local recurrences. Two patients died of metastatic disease at 23 and 103 months postoperatively. No other patients have developed systemic disease. Sixteen patients underwent partial scapulectomy while eight underwent total scapulectomy. Functional outcome was better in the group undergoing partial scapulectomy with significantly higher MSTS 87 (30.8 versus 16.6), MSTS 93 (89.6 versus 68.3), and TESS (92.6 versus 74.9) scores than the total scapulectomy group.

CONCLUSION

Patients with primary chondrosarcoma of the scapula have an excellent oncologic prognosis with a very low local recurrence and metastatic rate. Functional outcomes are better for patients undergoing partial rather than total scapulectomy.

摘要

背景

肩胛骨是软骨肉瘤的常见发病部位。近期关于肩胛骨软骨肉瘤患者肿瘤学结局的研究存在分歧。本研究的目的是调查在一家大型肿瘤中心就诊的原发性肩胛骨软骨肉瘤患者的肿瘤学和功能结局。

方法

对我们前瞻性收集的数据库进行回顾。纳入1989年至2004年间所有接受原发性肩胛骨软骨肉瘤手术切除的患者。我们记录了患者的人口统计学资料、患者是否接受了部分或全肩胛骨切除术、肿瘤学结局(包括局部和全身复发)以及使用肌肉骨骼肿瘤学会(MSTS)87、MSTS 93和多伦多肢体挽救评分(TESS)系统的功能结局。

结果

24例患者(16例男性,8例女性),平均年龄44岁(范围18 - 74岁),符合纳入标准。无局部复发。2例患者术后23个月和103个月死于转移性疾病。无其他患者发生全身性疾病。16例患者接受了部分肩胛骨切除术,8例接受了全肩胛骨切除术。部分肩胛骨切除术组的功能结局更好,其MSTS 87评分(30.8对16.6)、MSTS 93评分(89.6对68.3)和TESS评分(92.6对74.9)显著高于全肩胛骨切除术组。

结论

原发性肩胛骨软骨肉瘤患者具有良好的肿瘤学预后,局部复发和转移率极低。部分肩胛骨切除术患者的功能结局优于全肩胛骨切除术患者。

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