García-Jiménez A, Trullols-Tarragó L, Peiró-Ibáñez A, Gracia-Alegría I
Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Unidad de Cirugía Oncológica Ortopédica, Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Rev Esp Cir Ortop Traumatol. 2016 Nov-Dec;60(6):366-371. doi: 10.1016/j.recot.2016.06.006. Epub 2016 Sep 13.
Patients from other centres where they have had an unplanned surgical resection of a soft tissue sarcoma are often referred to hospitals specialised in sarcomas.
A study was conducted on 35 patients who required this type of surgery were referred to our center between November 2001 and July 2013.
Surgery had been performed on 29% of the patients without any complementary tests being done. In 75% of cases, the sarcoma diagnosis was discovered in the post-surgical histological study. Synovial sarcoma was the most common, affecting 38% of the patients. A surgical revision of the margins was performed on all of them, and adjuvant treatment was performed on 86% of them. The histopathology study found that 69% of the patients had residual disease. At the end of follow-up, 12% had a local recurrence, another 12% distant metastases, and 3% had died.
Given the results, it is concluded that any tumour of the soft tissues in which malignancy is suspected has to be resected in a reference centre. If an unplanned esection was performed in another centre, it should be referred immediately in order to perform an imaging study, revision surgery, and if required, adjuvant treatment.
来自其他中心、在那里接受过软组织肉瘤意外手术切除的患者，常常会被转诊至肉瘤专科医院。
对2001年11月至2013年7月间转诊至我们中心、需要进行此类手术的35例患者进行了一项研究。
29%的患者在未进行任何辅助检查的情况下接受了手术。在75%的病例中，肉瘤诊断是在术后组织学研究中发现的。滑膜肉瘤最为常见，占患者的38%。所有患者均进行了切缘的手术修正，86%的患者接受了辅助治疗。组织病理学研究发现，69%的患者有残留病灶。随访结束时，12%的患者出现局部复发，另有12%发生远处转移，3%的患者死亡。
基于这些结果，得出结论：任何疑似恶性的软组织肿瘤都必须在参考中心进行切除。如果在另一个中心进行了意外切除，应立即转诊，以便进行影像学检查、修正手术，并在需要时进行辅助治疗。
