Morii T, Yabe H, Morioka H, Anazawa U, Suzuki Y, Toyama Y
Department of Orthopaedics Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku, Tokyo 160-8582, Japan.
Open Orthop J. 2008 Jul 30;2:126-9. doi: 10.2174/1874325000802010126.
Unplanned resection of musculoskeletal sarcoma involves tumor excision without any suspicion of malignancy or regard for the necessity of defining adequate margins. For orthopaedic oncologists, many opportunities arise for management of unplanned resections initially performed by non-specialist surgeons. The puropose of this study is to assess the clinical outcomes and the problems of the patients with unplanned resection of high-grade soft tissue sarcoma.
77 consecutive patients were retrospectively reviewed. Oncological outcomes together with validity and problems of additional treatments were analyzed.
Five-year local recurrence-free survival, metastasis-free survival, event-free survival and total survival were 71.55%, 73.2%, 57.5% and 85.9%, respectively. Among adjuvant therapy including additional wide resection, radiotherapy and systemic chemotherapy, only additional wide resection significantly improved oncological outcomes.
Additional wide resection appears to be effective in the treatment of high-grade soft tissue sarcomas following primary resection with compromised margins of resection.
肌肉骨骼肉瘤的意外切除是指在未怀疑有恶性肿瘤或未考虑确定足够切缘必要性的情况下进行肿瘤切除。对于骨科肿瘤学家而言，由非专科外科医生最初进行的意外切除的处理机会很多。本研究的目的是评估高级别软组织肉瘤意外切除患者的临床结局及问题。
对77例连续患者进行回顾性研究。分析肿瘤学结局以及额外治疗的有效性和问题。
5年局部无复发生存率、无转移生存率、无事件生存率和总生存率分别为71.55%、73.2%、57.5%和85.9%。在包括额外广泛切除、放疗和全身化疗在内的辅助治疗中，只有额外广泛切除显著改善了肿瘤学结局。
对于初次切除切缘不足的高级别软组织肉瘤，额外广泛切除似乎是有效的治疗方法。
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