Tiwari Akshay, Shah Swati, Sharma Ashwani Kumar, Mehta Sandeep, Batra Ullas, Sharma S K, Dewan A K
Department of Surgical Oncology, Rajiv Gandhi Cancer Institute, Sector 5, Rohini, Delhi 110085 India.
Department of Reconstructive Surgery, BLK Cancer Center, Delhi, India.
Indian J Surg Oncol. 2017 Jun;8(2):128-135. doi: 10.1007/s13193-016-0569-2. Epub 2016 Nov 2.
Soft tissue sarcomas are a rare entity. While surgery is established as the mainstay of treatment, the exact role and sequencing of adjuvant therapy is not well defined. Literature on Indian patients with soft tissue sarcoma with respect to clinical profile and prognostic factors is scarce. We retrospectively analysed the data of 112 patients operated for soft tissue sarcoma of extremity or trunk (excluding retroperitoneal and mediastinal sarcomas, round cell histology) at our institute from 1 January 2009 to 31 December 2013. Around half the patients were less than 50 years of age and around a third had size more than 10 cm. Oncological outcome was correlated with various demographic, tumour-related and treatment-related factors using SPSS 22. Overall survival at 5 years was 73.2 % and event-free survival at 5 years was 42.2 %. At final follow-up (mean of 44.85 ± 4.64 months), local recurrence was seen in 31.9 % and distant metastasis was seen in 30.1 % of the patients. Using both univariate and multivariate analysis, younger age (<50 years), larger size (>10 cm, but not >5 cm) and pathologically positive lymph nodes were the only factors found significantly affecting overall survival. The clinical profile and prognosis of Indian patients with soft tissue sarcoma were found to be different from that reported in Western literature. The impact of established prognostic indicators for soft tissue sarcoma also differed in Indian patients, which may have both prognostic and therapeutic implications.
软组织肉瘤是一种罕见的疾病。虽然手术是既定的主要治疗方法，但辅助治疗的确切作用和顺序尚未明确界定。关于印度软组织肉瘤患者的临床特征和预后因素的文献很少。我们回顾性分析了2009年1月1日至2013年12月31日在我院接受手术治疗的112例肢体或躯干软组织肉瘤患者（不包括腹膜后和纵隔肉瘤、圆形细胞组织学类型）的数据。大约一半的患者年龄小于50岁，约三分之一的患者肿瘤大小超过10厘米。使用SPSS 22将肿瘤学结局与各种人口统计学、肿瘤相关和治疗相关因素进行关联分析。5年总生存率为73.2%，5年无事件生存率为42.2%。在最后随访时（平均44.85±4.64个月），31.9%的患者出现局部复发，30.1%的患者出现远处转移。通过单因素和多因素分析发现，年龄较小（<50岁）、肿瘤较大（>10厘米，但不>5厘米）和病理检查淋巴结阳性是仅有的显著影响总生存的因素。发现印度软组织肉瘤患者的临床特征和预后与西方文献报道的不同。软组织肉瘤既定预后指标的影响在印度患者中也有所不同，这可能具有预后和治疗两方面的意义。
