Department of Surgery, Tsukuba Central Hospital, Ushiku-shi 300-121, Japan.
World J Surg Oncol. 2011 Aug 24;9:96. doi: 10.1186/1477-7819-9-96.
Malignant fibrous histiocytoma (MFH) is an aggressive spindle cell cancer of soft-tissue sarcoma type in the elderly, mostly affecting the extremities. Lesions > 5 cm, positive margins, and local recurrence are significant poor prognostic indicators. The strongest predictor for distant metastasis was tumor size (> 5 cm), and for overall survival, presence of local recurrence. Limb-sparing extensive tumor resection is preferred to achieve negative surgical margins. However, in some circumstances, amputation is inevitable. Recent studies demonstrated that adjuvant radiotherapy for microscopically positive surgical margins significantly improved local control and disease-free survival rates. Therefore, effective therapeutic strategies against locally relapsed high grade MFH are required to prevent distant metastasis and to achieve long-term disease-free survival. Here, we report local relapse of high grade MFH treated by successive application of autologous formalin-fixed tumor vaccination (AFTV) with limb-sparing surgery and postoperative radiotherapy. The patient is alive and well, disease-free and with no functional impairment, more than five years after treatment.
恶性纤维组织细胞瘤（MFH）是一种侵袭性梭形细胞癌症，属于软组织肉瘤类型，多见于老年人，主要影响四肢。病灶>5cm、阳性切缘和局部复发是显著的预后不良指标。远处转移的最强预测因子是肿瘤大小（>5cm），而总生存率的预测因子是局部复发。为了获得阴性手术切缘，首选保肢广泛肿瘤切除术。然而，在某些情况下，截肢是不可避免的。最近的研究表明，对于显微镜下阳性手术切缘，辅助放疗可显著提高局部控制率和无病生存率。因此，需要针对局部复发性高级 MFH 制定有效的治疗策略，以预防远处转移并实现长期无病生存。在这里，我们报告了一例高级 MFH 局部复发患者，通过保肢手术和术后放疗先后应用自体福尔马林固定肿瘤疫苗（AFTV）治疗。患者在治疗后五年多，无病生存，无功能障碍，且情况良好。
