Musculoskeletal Oncology Service, Osaka International Cancer Institute, 3-1-69 Otemae, Chuou-ku, Osaka, 541-8567, Japan.
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Int J Clin Oncol. 2018 Feb;23(1):181-188. doi: 10.1007/s10147-017-1179-x. Epub 2017 Aug 10.
An epithelioid sarcoma is a rare histological subtype of a soft tissue sarcoma with a high local recurrence rate, which frequently shows lymph node metastasis. However, because of the rarity of this tumor, the impact of nodal metastasis and its appropriate management remain unclear. The present study investigated the clinical outcomes of patients with epithelioid sarcomas, with a focus on lymph node metastasis.
We retrospectively evaluated the clinical outcomes of 27 patients with epithelioid sarcomas treated between 1985 and 2015. The log-rank test was used to assess the prognostic variables.
The overall local recurrence rate was 33%, and the estimated overall 5-year survival rate was 62%. Hand and foot locations were associated with favorable overall survival. During the follow-up period, new nodal metastasis was noted in 14 patients (52%). The incidence of local recurrence was higher in patients with new nodal metastasis than in patients who did not develop nodal metastasis. The development of new nodal metastasis had a tendency to worsen survival; however, this association was not statistically significant. Lymphadenectomy did not affect overall survival.
Peripheral tumor location is associated with a better prognosis. The development of new nodal metastasis tends to be associated with poor prognosis; however, among patients with nodal metastasis, resection of the metastatic lesions has a low impact on survival.
上皮样肉瘤是一种罕见的软组织肉瘤组织学亚型，具有较高的局部复发率，常伴有淋巴结转移。然而，由于该肿瘤较为罕见，淋巴结转移的影响及其适当的处理仍不明确。本研究主要探讨了上皮样肉瘤患者的临床结局，重点在于淋巴结转移。
我们回顾性评估了 1985 年至 2015 年期间接受治疗的 27 例上皮样肉瘤患者的临床结局。采用对数秩检验评估预后变量。
总的局部复发率为 33%，估计的 5 年总生存率为 62%。手部和足部的位置与总体生存情况较好相关。在随访期间，14 例患者（52%）出现新的淋巴结转移。发生新的淋巴结转移的患者其局部复发率高于未发生淋巴结转移的患者。新的淋巴结转移的发生有恶化生存的趋势，但无统计学意义。淋巴结清扫术对总体生存率没有影响。
外周肿瘤位置与较好的预后相关。发生新的淋巴结转移往往与预后不良相关；然而，对于存在淋巴结转移的患者，切除转移病灶对生存的影响较低。
