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肢体脂肪肉瘤:新加坡一家大型三级医院所见及处理病例的回顾

Liposarcoma of the extremities: a review of the cases seen and managed in a major tertiary hospital in Singapore.

作者信息

Ng Y C S, Tan M H

机构信息

Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608.

出版信息

Singapore Med J. 2009 Sep;50(9):857-61.

PMID:19787170
Abstract

INTRODUCTION

Liposarcoma is one of the more common types of soft tissue sarcomas, presenting with a wide spectrum of clinical behaviour. However, there is little information on the outcome, management and survivability of patients with extremity liposarcoma in Singapore.

METHODS

A retrospective review of all the patients with extremity liposarcoma, diagnosed between 1997 and 2007, was performed. Univariate and multivariate statistics were used on the data to evaluate the clinical presentations, treatment, outcome and survivability of patients seen.

RESULTS

Over a ten-year period, 30 patients were seen for primary liposarcoma of the extremities. Three patients dropped out and 27 were managed and followed-up. Management included surgery and/or radiotherapy. Histological subtypes included 14 (51.9 percent) well-differentiated, five (18.5 percent) myxoid, four (14.8 percent) de-differentiated, and two (7.4 percent) each of round cell and pleomorphic variants. Four patients (14.8 percent) developed local or metastatic recurrent disease. The mean follow-up was 53 months, and the survival rate with primary disease at 53 months was 92.6 percent. The recurrence-free survival for primary disease at 53 months was 85.2 percent.

CONCLUSION

Liposarcoma of the extremities is relatively rare compared to other major soft tissue tumours. It is a highly pleomorphic disease, whose outcome is dependent on the histological subtype. Limb-sparing management includes wide resection of the tumour with/without radiation postoperatively.

摘要

引言

脂肪肉瘤是较为常见的软组织肉瘤类型之一,临床表现多样。然而,关于新加坡四肢脂肪肉瘤患者的治疗结果、管理及生存率的信息较少。

方法

对1997年至2007年间诊断为四肢脂肪肉瘤的所有患者进行回顾性研究。对数据进行单因素和多因素统计分析,以评估所观察患者的临床表现、治疗、结果及生存率。

结果

在十年期间,共诊治30例四肢原发性脂肪肉瘤患者。3例患者退出研究,27例接受了治疗和随访。治疗方法包括手术和/或放疗。组织学亚型包括14例(51.9%)高分化型、5例(18.5%)黏液型、4例(14.8%)去分化型,以及各2例(7.4%)的圆形细胞型和多形性变型。4例患者(14.8%)出现局部或转移性复发性疾病。平均随访时间为53个月,53个月时原发性疾病的生存率为92.6%。53个月时原发性疾病的无复发生存率为85.2%。

结论

与其他主要软组织肿瘤相比,四肢脂肪肉瘤相对少见。它是一种高度多形性疾病,其治疗结果取决于组织学亚型。保肢治疗包括广泛切除肿瘤并在术后进行或不进行放疗。

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