Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España.
Servicio de Cirugía Ortopédica y Traumatología, Hospital Arnau de Vilanova, Valencia, España.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2020 Sep-Oct;64(5):301-309. doi: 10.1016/j.recot.2020.04.010. Epub 2020 Jun 17.
Soft tissue sarcomas are exceptionally located in the elbow region. The aim of this work was to study the soft tissue sarcomas of the elbow region, their epidemiological and histopathological characteristics, anatomical features, the treatment performed, and the results obtained, in a unit of musculoskeletal tumours.
Retrospective review of ten patients with a mean follow-up of 65.0 ± 11.9 (range 21-132) months with soft tissue sarcomas located in the elbow region operated in our centre between 2008 and 2016.
Mean age was 60.8 ± 6.7 years. Undifferentiated pleomorphic sarcoma was the most frequent histological diagnosis. Limb preservation surgery was performed in 90% of patients. Three patients were previously operated without following surgical oncology guidelines in another hospital, and this was statistically related to the need for more than one surgery to control the disease. R1 margin was obtained in 5 patients and R0 in another 5. Adjuvant radiotherapy was used in 7 cases. In 4 patients, subsequent surgery was performed for local or systemic control of the disease. Local recurrence occurred in 3 cases and in 5 there was distant disease.
The elbow region presents difficulty in achieving wide margins due to the proximity of neurovascular structures, adjuvant and / or neoadjuvant therapies could play an important role in performing limb preservation surgery. It would be advisable to refer these tumours to specialized units with multidisciplinary teams.
软组织肉瘤在肘部区域的位置非常特殊。本研究旨在研究肘部区域的软组织肉瘤,包括其流行病学和组织病理学特征、解剖学特征、所采用的治疗方法以及在骨与软组织肿瘤治疗中心获得的结果。
对 2008 年至 2016 年间在本中心接受手术治疗的 10 例肘部软组织肉瘤患者进行回顾性分析,平均随访时间为 65.0±11.9 个月(范围为 21-132 个月)。
患者的平均年龄为 60.8±6.7 岁。未分化多形性肉瘤是最常见的组织学诊断。90%的患者接受了保肢手术。有 3 例患者在另一家医院未遵循外科肿瘤学指南进行了先前的手术,这与需要进行多次手术来控制疾病有关。5 例患者获得了 R0 切缘,另 5 例患者获得了 R1 切缘。7 例患者接受了辅助放疗。4 例患者因局部或全身疾病控制需要进行了后续手术。3 例患者出现局部复发,5 例患者出现远处转移。
由于肘部区域神经血管结构的临近,难以获得广泛的切缘,辅助和/或新辅助治疗可能在进行保肢手术中发挥重要作用。建议将这些肿瘤转介给具有多学科团队的专业治疗单位。