Sarcoma Center, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Department of Musculoskeletal Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Cancer Med. 2020 Sep;9(17):6159-6165. doi: 10.1002/cam4.3304. Epub 2020 Jul 10.
Hepatic metastasis of soft tissue sarcoma is rare compared to lung metastasis, and the literature is scarce. We examined the risk of hepatic metastasis according to the site of occurrence and histological type.
From a Hospital-based Cancer Registry, 658 patients registered between 2007 and 2017 with soft tissue sarcomas were evaluated. The exclusion criteria were gastrointestinal stromal tumors, tumors of unknown origin, and follow-up periods of less than 1 month. SPSS 25 was used for statistical analysis.
The risk of hepatic metastasis was significantly higher in the retroperitoneum (HR, 5.981; 95% CI, 2.793-12.808) and leiomyosarcoma (HR, 4.303; 95% CI, 1.782-10.390). Multivariate analysis showed that the risk of hepatic metastasis as first distant metastasis was high in leiomyosarcoma (HR, 4.546; 95% CI, 2.275-9.086) and retroperitoneal onset (HR, 4.588; 95% CI, 2.280-9.231). The 2-year survival rate after hepatic metastasis was 21.7%.
The onset of hepatic metastasis indicates a poor prognosis. However, hepatic metastasis from retroperitoneal sarcoma and leiomyosarcoma may be the first distant metastasis in some cases. For retroperitoneal sarcoma and leiomyosarcoma, additional screening for hepatic metastasis such as contrast CT should be considered during staging and follow-up after treatment.
与肺转移相比，软组织肉瘤的肝转移较为罕见，相关文献也较少。我们根据发病部位和组织学类型来检查肝转移的风险。
我们从医院癌症登记处评估了 2007 年至 2017 年间登记的 658 例软组织肉瘤患者。排除标准为胃肠道间质瘤、来源不明的肿瘤以及随访时间不足 1 个月的患者。采用 SPSS 25 进行统计分析。
腹膜后（HR，5.981；95%CI，2.793-12.808）和平滑肌肉瘤（HR，4.303；95%CI，1.782-10.390）发生肝转移的风险显著更高。多变量分析显示，平滑肌肉瘤（HR，4.546；95%CI，2.275-9.086）和腹膜后发病（HR，4.588；95%CI，2.280-9.231）是肝转移作为首发远处转移的高风险因素。肝转移后 2 年的生存率为 21.7%。
肝转移的发生预示着预后不良。然而，腹膜后肉瘤和平滑肌肉瘤的肝转移可能在某些情况下是首发的远处转移。对于腹膜后肉瘤和平滑肌肉瘤，在治疗后分期和随访期间，应考虑额外进行肝转移的筛查，如对比增强 CT。
