Division of Pediatrics, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Cancer. 2011 Jun 15;117(12):2728-34. doi: 10.1002/cncr.25736. Epub 2010 Dec 29.
Soft tissue sarcomas (STSs) arising from the popliteal fossa present a challenge with regard to local control of primary tumors. Due to concerns of functional morbidity and neurovascular compromise, there is debate about what represents the best therapy for these patients.
We conducted a retrospective medical record review of patients treated at The University of Texas M. D. Anderson Cancer Center for STS of the popliteal fossa from 1990 to 2008.
There were 47 eligible patients, 28 of whom were male and 19 of whom were female. Synovial sarcoma was the most common diagnosis, with 12 cases. Most patients had T2b tumors (31 patients; 66%). The median duration of follow-up was 3.8 years (range, 0.6-17.9 years). The 5- and 10-year overall survival rates were 63% and 51%, respectively. Metastasis at diagnosis was associated with poorer overall survival (5-year overall survival, 74% versus 13%; P<.001) and poorer recurrence-free survival (5-year recurrence-free survival, 51% versus 0%; P<.001) on univariate analysis. Radiation therapy improved local recurrence-free survival (5-year local recurrence-free survival, 56% versus 17%; P = .004), whereas a trend was observed for surgical margin status (P = .07). Tumor size and neurovascular involvement did not influence outcome. Twenty-two patients had recurrent disease, with 15 patients having local recurrence, and 16 patients died from progressive disease.
Radiation therapy may play an important role in the treatment of popliteal fossa STS, but further study is needed to better define the best clinical application. Additional study is needed to re-evaluate association of surgical margin status and outcome.
来自腘窝的软组织肉瘤（STS）在原发性肿瘤的局部控制方面带来了挑战。由于对功能发病率和神经血管损伤的担忧，对于这些患者的最佳治疗方法存在争议。
我们对 1990 年至 2008 年期间在德克萨斯大学 MD 安德森癌症中心接受腘窝 STS 治疗的患者进行了回顾性病历审查。
共有 47 名符合条件的患者，其中 28 名男性，19 名女性。滑膜肉瘤是最常见的诊断，有 12 例。大多数患者为 T2b 肿瘤（31 例；66%）。中位随访时间为 3.8 年（范围：0.6-17.9 年）。5 年和 10 年总生存率分别为 63%和 51%。诊断时发生转移与总生存率较差（5 年总生存率，74%比 13%；P<.001）和无复发生存率较差（5 年无复发生存率，51%比 0%；P<.001）相关。放疗改善了局部无复发生存率（5 年局部无复发生存率，56%比 17%；P =.004），而手术切缘状态也有改善趋势（P =.07）。肿瘤大小和神经血管受累并不影响预后。22 名患者发生疾病复发，其中 15 名患者发生局部复发，16 名患者死于疾病进展。
放疗可能在腘窝 STS 的治疗中发挥重要作用，但需要进一步研究以更好地确定最佳的临床应用。需要进一步研究来重新评估手术切缘状态与预后的关系。
