Mahmoud Ahmed Mostafa Ahmed, Mahmoud Mohammed, Charaf Ahmed, Moneer Manar Mohamed
Surgical Oncology Department, National Cancer Institute, Cairo University, Egypt.
Radiation Oncology Department, National Cancer Institute, Cairo University, Egypt.
J Egypt Natl Canc Inst. 2017 Jun;29(2):89-94. doi: 10.1016/j.jnci.2017.03.001. Epub 2017 Apr 24.
Proper surgery with adequate safety margin and adjuvant radiotherapy is the main line of treatment of extremity and trunk soft tissue sarcoma (STS). In spite of improved management, the long term follow up is still not satisfactory.
To evaluate long term outcome of STS of extremities and trunk regarding adequacy of resection, recurrence and survival.
This prospective study included 25 patients with STS involving extremity and trunk. All patients were treated with wide radical excision and had adjuvant irradiation and followed up for a median of 26months.
The mean age was 40.0±15.3years. They were 16 males and 9 females. Eight patients (32%) had positive or close surgical margins. The median overall survival (OS) was 26.5months. In univariate analysis, lower limb tumors, stage III and grade 3 were significantly associated with worse overall survival (OS) (p=0.007, 0.02, and 0.020, respectively) and disease free survival (DFS) (p=0.005, 0.001, and 0.001, respectively). On multivariate analysis the only independent factor that affects the OS and DFS was the stage (p value=0.029, Hazard ratio: 3.64, 95% confidence interval: 1.14-11.61 and p value=0.003, Hazard ratio: 5.75, 95% confidence interval: 1.82-18.18 respectively).
Despite adequate surgery and adjuvant irradiation, 5years follow up results of treatment of extremity and trunk soft tissue sarcoma is still poor. This highlights the importance of early detection of small STS in extremity and trunk.
采用具有足够安全切缘的恰当手术及辅助放疗是肢体和躯干软组织肉瘤（STS）的主要治疗方法。尽管治疗有所改善，但长期随访结果仍不尽人意。
评估肢体和躯干STS在切除充分性、复发及生存方面的长期结局。
这项前瞻性研究纳入了25例累及肢体和躯干的STS患者。所有患者均接受了广泛根治性切除，并接受了辅助放疗，中位随访时间为26个月。
平均年龄为40.0±15.3岁。男性16例，女性9例。8例患者（32%）手术切缘阳性或接近阳性。中位总生存期（OS）为26.5个月。单因素分析显示，下肢肿瘤、Ⅲ期和3级与较差的总生存期（OS）显著相关（分别为p=0.007、0.02和0.020）以及无病生存期（DFS）（分别为p=0.005、0.001和0.001）。多因素分析显示，影响OS和DFS的唯一独立因素是分期（p值=0.029，风险比：3.64，95%置信区间：1.14-11.61；p值=0.003，风险比：5.75，95%置信区间：1.82-18.18）。
尽管进行了充分的手术和辅助放疗，但肢体和躯干软组织肉瘤治疗的5年随访结果仍然较差。这凸显了早期发现肢体和躯干小STS的重要性。
