Division of Surgical Oncology, Emory Winship Cancer Institute, USA.
Curr Probl Cancer. 2013 Mar-Apr;37(2):62-73. doi: 10.1016/j.currproblcancer.2013.03.002.
Limb-sparing surgery with the preservation of limb function, with or without radiation therapy, is the standard surgical approach for patients with STS of the extremity. In the current era of limb-sparing surgery, most modern series report a local recurrence rate of approximately 15%-20%. Numerous factors are independently associated with the development of a local recurrence, and therefore even in the face of a negative margin, patients are at risk for a local recurrence and decreased OS. Systemic chemotherapy for decreasing local recurrence rates and improving survival has been studied for decades. When the various disease entities within the classification of STS are grouped together and studied as one, the effect of chemotherapy on OS is modest at best. However, there are clearly patients who do benefit from such therapy and tools to better identify these patients may be on the horizon. New efficacious agents with improved toxicity profiles will also benefit this population significantly.
保肢手术保留肢体功能，可联合或不联合放射治疗，是肢体软组织肉瘤（STS）患者的标准手术方法。在当前的保肢手术时代，大多数现代系列研究报告局部复发率约为 15%-20%。许多因素与局部复发的发生独立相关，因此，即使切缘阴性，患者仍有局部复发和降低总生存率（OS）的风险。数十年来，人们一直在研究全身性化疗以降低局部复发率和提高生存率。当将 STS 分类中的各种疾病实体作为一个整体进行研究时，化疗对 OS 的影响充其量只是适度的。然而，显然有一些患者从这种治疗中获益，更好地识别这些患者的工具可能即将出现。具有改善毒性特征的新型有效药物也将使这一人群显著受益。
