Nota S P F T, Russchen M J A M, Raskin K A, Mankin H J, Hornicek F J, Schwab J H
Orthopaedic Oncology Service, Massachusetts General Hospital - Harvard Medical School, Yawkey Center, Suite 3B, 55 Fruit Street, Boston, MA, 02114, USA.
Musculoskelet Surg. 2017 Apr;101(1):67-73. doi: 10.1007/s12306-016-0437-9. Epub 2016 Nov 29.
The scapula is a relatively common site for chondrosarcoma to develop in contrary to the clavicle, which is rarely affected by these tumors. The aim of this study is to determine the functional and oncological outcome for patients treated operatively for scapular or clavicular chondrosarcoma.
In this single-center retrospective study, we included a sample of 20 patients that received the diagnosis of a primary chondrosarcoma of the scapula or clavicle. Of the surviving patients, the functional function was assessed using the DASH and the PROMIS Physical Function-Upper Extremity. Patients were longitudinally tracked for their oncological outcome.
All patients were followed for at least 2 years or until death. The mean age of the cohort was 47 years. Eighteen patients suffered from a chondrosarcoma of the scapula, and in 2 patients, the tumor was located in the clavicle. Metastasis, local recurrence and a higher tumor grade were all associated with a decreased overall survival. For the patients with a chondrosarcoma of the scapula, the average DASH score was 16 ± 16 and the mean PROMIS Physical Function-Upper Extremity score was 48 ± 10. Patients with both an intact rotator cuff and glenoid had a better physical function.
Upper extremity function after (partial) scapulectomy varied depending on whether the glenoid was spared and whether a functioning shoulder abductor remained. When the resection spared these structures, then excellent functional outcomes were reported. Oncologic outcomes depended upon the grade of the tumor and whether local recurrence and metastases occurred.
与很少受这些肿瘤影响的锁骨相反，肩胛骨是软骨肉瘤相对常见的发病部位。本研究的目的是确定接受肩胛骨或锁骨软骨肉瘤手术治疗患者的功能和肿瘤学结局。
在这项单中心回顾性研究中，我们纳入了20例被诊断为原发性肩胛骨或锁骨软骨肉瘤的患者样本。在存活患者中，使用上肢功能障碍量表（DASH）和上肢物理功能患者报告结局测量信息系统（PROMIS Physical Function-Upper Extremity）评估功能。对患者的肿瘤学结局进行纵向跟踪。
所有患者均随访至少2年或直至死亡。队列的平均年龄为47岁。18例患者患有肩胛骨软骨肉瘤，2例患者肿瘤位于锁骨。转移、局部复发和更高的肿瘤分级均与总生存率降低相关。对于患有肩胛骨软骨肉瘤的患者，平均DASH评分为16±16，平均PROMIS上肢物理功能评分为48±10。肩袖和关节盂均完整的患者身体功能更好。
（部分）肩胛骨切除术后的上肢功能因关节盂是否保留以及是否保留有功能的肩关节外展肌而异。当切除保留这些结构时，则报告了优异的功能结局。肿瘤学结局取决于肿瘤分级以及是否发生局部复发和转移。
