Nakamura Tomoki, Nakamura Koichi, Hagi Tomohito, Asanuma Kunihiro, Sudo Akihiro
Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan.
J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019840813. doi: 10.1177/2309499019840813.
Soft tissue sarcomas (STSs) of the thigh's adductor compartment frequently attain a large size before clinical presentation and displace the major neurovascular and lymph structures. We aimed to elucidate the clinical outcome in patients with STS of the thigh's adductor compartment.
From March 1999 to June 2016, we treated 24 adult patients with primary STS of the thigh's adductor compartment.
The mean age at diagnosis was 60 years. There were 13 men and 11 women. The mean follow-up period after the date of the initial treatment was 84 months. The mean tumor size at diagnosis was 13.6 cm. The disease-specific survival was 75.3% at 5 years. Local recurrence was detected in seven patients. The 5-year local recurrence-free rate was 69.9%. The patients with proximal STS had significantly poorer local control, compared to the remaining patients. Twelve (50%) patients developed 14 surgical wound complications. Complications included wound dehiscence ( n = 7), infections ( n = 6), lymphorrhea ( n = 1), wound dehiscence and infection ( n = 1), and infection and lymphorrhea ( n = 1). Six patients underwent additional surgical treatment. Intraoperative blood loss and operative time were related to the incidence of wound complications. Intraoperative blood loss and operative time in patients with proximal adductor STS were significantly larger than those in the remaining patients.
We should take care of patients with STS of the thigh's adductor compartment, especially for proximal adductor STS, because they have a greater risk of local recurrence and wound complications.
大腿内收肌间隙的软组织肉瘤（STS）在临床表现前常长得很大，并使主要神经血管和淋巴结构移位。我们旨在阐明大腿内收肌间隙STS患者的临床结局。
1999年3月至2016年6月，我们治疗了24例大腿内收肌间隙原发性STS的成年患者。
诊断时的平均年龄为60岁。男性13例，女性11例。初始治疗日期后的平均随访期为84个月。诊断时的平均肿瘤大小为13.6 cm。5年疾病特异性生存率为75.3%。7例患者检测到局部复发。5年局部无复发生存率为69.9%。与其余患者相比，近端STS患者的局部控制明显较差。12例（50%）患者出现14例手术伤口并发症。并发症包括伤口裂开（n = 7）、感染（n = 6）、淋巴漏（n = 1）、伤口裂开合并感染（n = 1）以及感染合并淋巴漏（n = 1）。6例患者接受了额外的手术治疗。术中失血和手术时间与伤口并发症的发生率相关。近端内收肌STS患者的术中失血和手术时间明显长于其余患者。
我们应关注大腿内收肌间隙STS患者，尤其是近端内收肌STS患者，因为他们有更高的局部复发和伤口并发症风险。
