Baroudi Maher R, Ferguson Peter C, Wunder Jay S, Isler Marc H, Mottard Sophie, Werier Joel A, Turcotte Robert E
Orthopaedic Surgery, Montreal General Hospital, Montreal, Quebec, Canada.
J Surg Oncol. 2014 Nov;110(6):676-81. doi: 10.1002/jso.23686. Epub 2014 Jun 9.
Complex anatomy of the forearm may impact on local control and survivals of soft tissue sarcoma. Little is known about characteristics and oncologic outcomes following surgical treatment.
Demographic and tumor data of 117 patients with forearm soft tissue sarcoma were collected and analyzed. Following limb salvage, survivals, and prognostic factors were studied.
Seventy-three patients were males (62%) and 53 (45%) were referred after unplanned excision. Pleomorphic undifferentiated sarcoma was most frequent (45%). The average tumor size was 5.1 cm and grade III histology was mostly identified (53%). With radiotherapy, local recurrence occurs in 8 patients (7%) and 30 patients (24%) developed metastasis. Overall survival, disease free survival, local recurrence free survival, and metastasis free survival were 83%, 74%, 93%, and 74%, respectively. Better survival was found for grade I (80% vs. 60%) and small size (<5 cm) (72% vs. 47%). Large size tumor, extra-compartmental site, extramuscular, and virgin tumor were positive predictors of metastasis.
Soft tissue sarcomas of the forearm are often referred after unplanned excision. Limb salvage was achieved for most and local recurrence remained low in context of radiotherapy. Metastatic progression remained frequent. Low grade and small size were predictors of survival.
前臂复杂的解剖结构可能会影响软组织肉瘤的局部控制和生存率。关于手术治疗后的特征和肿瘤学结果知之甚少。
收集并分析了117例前臂软组织肉瘤患者的人口统计学和肿瘤数据。在保肢术后，对生存率和预后因素进行了研究。
73例患者为男性（62%），53例（45%）在计划外切除后转诊。多形性未分化肉瘤最为常见（45%）。肿瘤平均大小为5.1厘米，大多为III级组织学（53%）。接受放疗后，8例患者（7%）出现局部复发，30例患者（24%）发生转移。总生存率、无病生存率、无局部复发生存率和无转移生存率分别为83%、74%、93%和74%。I级（80%对60%）和小尺寸（<5厘米）（72%对47%）的患者生存率更高。肿瘤尺寸大、筋膜外部位、肌肉外和初发肿瘤是转移的阳性预测因素。
前臂软组织肉瘤常在计划外切除后转诊。大多数患者实现了保肢，在放疗情况下局部复发率仍然较低。转移进展仍然很常见。低级别和小尺寸是生存的预测因素。
