Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
University Hospital Zurich, Zurich, Switzerland.
J Surg Oncol. 2020 Mar;121(4):605-611. doi: 10.1002/jso.25856. Epub 2020 Jan 31.
Abdominal metastases (AM) from soft tissue sarcoma (STS) are rare and prognosis is poor. The aims of the study were to (a) identify risk factors for the development of AM and to (b) investigate the outcome of AM-patients.
Seven-hundred-sixty-nine STS-patients with localised disease at diagnosis treated at three tumour centres (2000-2016) were retrospectively included (409 males; mean age, 55.6 years [range, 8-96 years]; median follow-up, 4.1 years [interquartile-range, 2.5-6.6 years]).
Two-hundred-two patients (26.3%) developed secondary metastases, and 24 of them AM (3.1%). Ten patients developed first AM (FAM) after a mean of 2.4 years and 14 patients late AM (LAM, after being diagnosed with metastases to other sites) after a mean of 2.0 years. Patients with liposarcoma had a significantly higher risk of developing AM (P = .007), irrespective of grading. There was no difference in post-metastasis-survival (PMS) between patients with AM at any time point and those with metastases to other sites (P = .585). Patients with LAM or FAM showed no difference in post-abdominal-metastasis-survival (P = .884).
Survival in patients with AM is poor, irrespective of whether they develop secondarily to other metastases or not. Patients at high-risk of AM (ie, liposarcoma) may be followed-up regularly by abdominal-ultrasound/CT.
软组织肉瘤(STS)的腹部转移(AM)较为罕见,预后较差。本研究的目的在于:(a)确定发生 AM 的风险因素;(b)调查 AM 患者的预后。
回顾性纳入了 3 个肿瘤中心(2000-2016 年)诊断为局限性疾病的 769 例 STS 患者(409 例男性;平均年龄 55.6 岁[范围:8-96 岁];中位随访时间 4.1 年[四分位间距:2.5-6.6 年])。
202 例患者(26.3%)发生了继发性转移,其中 24 例为 AM(3.1%)。10 例患者首次出现 AM(FAM),平均时间为 2.4 年,14 例患者出现晚期 AM(LAM,在诊断为其他部位转移后),平均时间为 2.0 年。脂肪肉瘤患者发生 AM 的风险显著更高(P=0.007),而与分级无关。在任何时间点发生 AM 的患者与发生其他部位转移的患者的转移后生存(PMS)无差异(P=0.585)。LAM 或 FAM 患者的腹部转移后生存无差异(P=0.884)。
无论是否继发于其他转移,AM 患者的生存状况均较差。(高危 AM 的患者,即脂肪肉瘤患者)可能需要定期通过腹部超声/CT 进行随访。