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非计划性初次手术后软组织肉瘤的广泛切除:一项长期随访研究。

Wide resection of soft tissue sarcomas after unplanned primary procedures: A long-term follow-up study.

作者信息

Kang Jian, Xu Ming, Wang Bing, Yu Xiuchun

机构信息

Department of Orthopaedics, The 960th hospital of People's Liberation Army, 25 Shifan Road, Jinan, Shandong Province, China.

出版信息

Medicine (Baltimore). 2020 Feb;99(8):e19067. doi: 10.1097/MD.0000000000019067.

Abstract

Unplanned resection of soft-tissue sarcomas (STS) predispose the patients to recurrences and metastases, secondary wide resection is usually warranted.To investigate the outcomes of re-excision of STS after unplanned initial resection.The records of 39 patients undergoing re-excision of STS after unplanned initial resection from January 2006 through December 2015 were retrospectively investigated.There were 17 males and 22 females, the mean age was 45.7 years. Most initial unplanned resections were performed in rural hospitals by surgeons from general surgery department, dermatology department, plastic surgery department, and orthopedic department. Thirty-five patients underwent secondary wide resections in our department. Histopathological findings indicated positive margins after primary surgeries in 18 patients. Until the conclusion of 37.2-month follow-up, 7 patients developed metastasis, 3 had local recurrence, and 7 were dead. Positive margins were associated with increased metastases and lower survival rates (P < .05). There was no significant difference in recurrences between the 2 groups.Unplanned initial resection of STS often lead to unfavorable prognosis. Primary wide resections are warranted for this disease entity.

摘要

软组织肉瘤(STS)的意外切除会使患者易于复发和转移,通常需要进行二期广泛切除。为了研究意外初次切除后STS再次切除的结果。回顾性调查了2006年1月至2015年12月期间39例意外初次切除后接受STS再次切除患者的记录。男性17例,女性22例,平均年龄45.7岁。大多数初次意外切除是由农村医院的普通外科、皮肤科、整形外科和骨科医生进行的。35例患者在我科接受了二期广泛切除。组织病理学结果显示,18例患者初次手术后切缘阳性。截至37.2个月随访结束时,7例患者发生转移,3例局部复发,7例死亡。切缘阳性与转移增加和生存率降低相关(P<0.05)。两组之间的复发率无显著差异。STS的意外初次切除常导致不良预后。对于这种疾病实体,初次广泛切除是必要的。

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