Jubbal Kevin T, D'Souza Gehaan, Abrams Reid A, Kulidjian Anna A
University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA.
Division of Plastic Surgery, University of California, San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA.
SICOT J. 2017;3:47. doi: 10.1051/sicotj/2017001. Epub 2017 Jun 28.
Management of malignant tumors of the hand and wrist is challenging and is generally approached by limb salvage or amputation. With advances in care, amputation has been superseded by limb salvage as the treatment of choice.
A narrative literature review was performed to identify articles on the topic of management of soft tissue tumors of the upper extremity, including surgical management, adjuvant radiation therapy, and chemotherapy.
A total of 29 articles were selected. Earlier reports favored radical tumor resection, which often led to amputation, whereas later articles demonstrated limb salvage as the preferential treatment modality.
Given the detrimental effects on function and psychologic outcomes, amputation has been superseded by limb salvage in most cases, although it can occasionally be the only option. A variety of adjuvant therapies have been described, including radiation or brachytherapy, chemotherapy, and regional hyperthermia. Radiation treatment, and specifically brachytherapy, is beneficial to select patients. Controversy surrounds chemotherapy in certain subtypes, and regional hyperthermia requires further investigation.
手部和腕部恶性肿瘤的治疗颇具挑战性，一般采用保肢或截肢手术。随着医疗水平的进步，保肢手术已取代截肢手术成为首选治疗方法。
进行叙述性文献综述，以确定有关上肢软组织肿瘤治疗主题的文章，包括手术治疗、辅助放疗和化疗。
共筛选出29篇文章。早期报告倾向于根治性肿瘤切除术，这通常会导致截肢，而后期文章表明保肢手术是更可取的治疗方式。
鉴于截肢对功能和心理状况有不利影响，在大多数情况下，保肢手术已取代截肢手术，尽管截肢偶尔可能是唯一选择。已描述了多种辅助治疗方法，包括放疗或近距离放疗、化疗和区域热疗。放射治疗，特别是近距离放疗，对特定患者有益。某些亚型的化疗存在争议，区域热疗需要进一步研究。
