Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Musculoskeletal Tumor Center, Seoul National University Cancer Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea.
Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea.
Eur J Surg Oncol. 2014 Apr;40(4):406-11. doi: 10.1016/j.ejso.2013.12.010. Epub 2013 Dec 25.
T1 (≤5 cm) soft tissue sarcoma (STS) may represent a distinct subgroup with different biological characteristics resulting in favorable outcomes, when compared with T2 (>5 cm) STS. However, only few studies focusing on T1 STS have been reported.
A retrospective review was conducted on 373 patients (163 with T1 STS [T1 group] and 210 with T2 STS [T2 group]) who underwent surgical removal of STS. Clinicopathologic characteristics and prognostic factors for local recurrence and disease-specific survival (DSS) of T1 STS was investigated and compared with those of T2 STS.
T1 group was younger (p = 0.004), had fewer metastases at initial presentation (p < 0.001), more previous unplanned excisions (p < 0.001), more synovial sarcomas (p = 0.024), fewer liposarcomas (p < 0.001), lower histological grade (p = 0.013), and fewer deep-seated tumors (p < 0.001) than T2 group. For local recurrence, older age (p = 0.008), previous unplanned excision (p = 0.012), and malignant peripheral nerve sheath tumor subtype (p = 0.014) independently predicted poor prognosis in the T2 group whereas only anatomical site of lower extremity (p = 0.046) was a favorable prognostic factor in the T1 group. For DSS, higher histologic grade (p = 0.037) and larger tumor size (p = 0.020) predicted poor prognosis in T2 group whereas only older age (p = 0.005) was prognostic in the T1 group.
Clinicopathological characteristics and prognostic factors of T1 STS differed from those of T2 STS. Established prognostic factors for STS were of limited value for T1 STS. These findings suggest the necessity of a different assessment strategy for T1 STS.
与 T2（>5cm）软组织肉瘤（STS）相比，T1（≤5cm）STS 可能代表具有不同生物学特征的独特亚组，从而获得较好的结果。然而，仅有少数关注 T1STS 的研究被报道。
对 373 例接受 STS 切除手术的患者（163 例 T1STS [T1 组]和 210 例 T2STS [T2 组]）进行回顾性研究。分析 T1STS 的临床病理特征和局部复发及疾病特异性生存（DSS）的预后因素，并与 T2STS 进行比较。
T1 组患者更年轻（p=0.004），初始表现时转移更少（p<0.001），既往计划外切除更多（p<0.001），滑膜肉瘤更多（p=0.024），脂肪肉瘤更少（p<0.001），组织学分级更低（p=0.013），深部肿瘤更少（p<0.001）。对于局部复发，T2 组中年龄较大（p=0.008）、既往计划外切除（p=0.012）和恶性外周神经鞘瘤亚型（p=0.014）是不良预后的独立预测因素，而 T1 组中仅下肢解剖部位（p=0.046）是有利的预后因素。对于 DSS，T2 组中组织学分级较高（p=0.037）和肿瘤较大（p=0.020）预示预后不良，而 T1 组中仅年龄较大（p=0.005）是预后因素。
T1STS 的临床病理特征和预后因素与 T2STS 不同。STS 的既定预后因素对 T1STS 的价值有限。这些发现表明需要对 T1STS 采用不同的评估策略。
