OrthoIndy, 8450 Northwest Blvd, Indianapolis, IN 46278, USA.
Clin Orthop Relat Res. 2012 Mar;470(3):706-11. doi: 10.1007/s11999-011-2192-4.
It is commonly assumed patients with high-grade soft tissue sarcomas who are diagnosed and treated quickly after the first onset of symptoms fare better than those with longer symptoms before treatment. The literature contains no substantive data to support this assumption for soft tissue sarcomas, particularly for high-grade lesions.
QUESTIONS/PURPOSES: We examined selected potential prognostic factors for high-grade soft tissue sarcoma and determined whether the time from first symptom to diagnosis has an impact on survival or disease-free survival and whether subcutaneous sarcomas are diagnosed more quickly than deep sarcomas.
We retrospectively reviewed 381 consecutive patients treated for high-grade soft tissue sarcoma between 1992 and 2007. Each patient's time from first symptom (pain and/or palpable mass) was prospectively entered into a surgical oncology database. The patients were followed for disease recurrence and survival. We compared length of symptoms with disease-free survival, overall survival, metastases at diagnosis, tumor size, and patient age. Minimum followup was 1 month (mean, 57 months; range, 1-201 months).
The overall 5-year survival was 64.7% and disease-free survival was 54.5%. Tumor size and metastatic disease correlated with overall survival and disease-free survival but not length of symptoms. Length of symptoms did not correlate with overall survival or disease-free survival.
Our data do not support the assumption that longer length of symptoms before diagnosis predicts worse overall survival, disease-free survival, or metastatic disease at diagnosis.
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
人们普遍认为，首次出现症状后迅速诊断和治疗的高级别软组织肉瘤患者比那些在治疗前有较长症状的患者预后更好。但该文献并没有为软组织肉瘤，尤其是高级别病变提供实质性数据来支持这一假设。
问题/目的：我们研究了高级别软组织肉瘤的一些潜在预后因素，并确定首次症状到诊断的时间是否会对生存或无病生存产生影响，以及皮下肉瘤是否比深部肉瘤更快被诊断出来。
我们回顾性分析了 1992 年至 2007 年间连续治疗的 381 例高级别软组织肉瘤患者。每位患者的首次症状（疼痛和/或可触及肿块）时间均前瞻性地输入到外科肿瘤学数据库中。对患者进行疾病复发和生存随访。我们比较了症状持续时间与无病生存、总生存、诊断时的转移、肿瘤大小和患者年龄。最小随访时间为 1 个月（平均随访时间为 57 个月，范围为 1-201 个月）。
总的 5 年生存率为 64.7%，无病生存率为 54.5%。肿瘤大小和转移性疾病与总生存和无病生存相关，但与症状持续时间无关。症状持续时间与总生存或无病生存无关。
我们的数据不支持这样的假设，即诊断前较长的症状持续时间预示着更差的总体生存率、无病生存率或诊断时的转移疾病。
II 级，预后研究。有关证据水平的完整描述，请参见作者指南。
