Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan;
Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
In Vivo. 2022 Sep-Oct;36(5):2260-2264. doi: 10.21873/invivo.12954.
BACKGROUND/AIM: Distant metastasis has a strong influence on prognosis in patients with soft tissue sarcoma (STS). While various risk factors have been reported for distant metastases, risk factors for distant metastases early after treatment of primary tumor have not been investigated. This study aimed to evaluate the factors of early distant metastasis after primary tumor resection in patients with STS.
We retrospectively identified patients with STS involving the extremities or trunk without any metastasis at the first visit. Data on clinical information and detailed assessment were collected. We evaluated clinical information as a risk factor for distant or lung metastases. Additionally, we evaluated risk factors for metastases in patients with distant metastases as early as 6 months after the initial resection of the primary tumor.
A total of 337 patients were included in the study. Multivariate analysis revealed that the size of the primary tumor (p=0.0011 and p=0.0167), consultation in a short period after onset (p=0.0325 and p=0.0402), histological high grade (p=0.0006 and p=0.0002), and inadequate surgical margin (p=0.0151 and p=0.0055) were significant predictors for poor prognosis for all distant and lung metastases, respectively. However, the only risk factor for early metastases within 6 months was young age (p=0.0148).
The only risk factor for early distant metastasis after primary tumor resection in patients with STS was young age, even though large tumor diameter and histological high grade were risk factors for distant metastasis.
背景/目的：远处转移对软组织肉瘤（STS）患者的预后有很大影响。虽然已经报道了多种远处转移的危险因素，但尚未研究原发性肿瘤治疗后早期远处转移的危险因素。本研究旨在评估 STS 患者原发性肿瘤切除后早期远处转移的相关因素。
我们回顾性地确定了初诊时无任何转移的四肢或躯干软组织肉瘤患者。收集了临床信息和详细评估数据。我们评估了临床信息是否为远处或肺转移的危险因素。此外，我们评估了原发性肿瘤初次切除后 6 个月内发生远处转移的患者的转移危险因素。
共有 337 例患者纳入研究。多变量分析显示，肿瘤大小（p=0.0011 和 p=0.0167）、初诊后就诊时间短（p=0.0325 和 p=0.0402）、组织学高级别（p=0.0006 和 p=0.0002）以及手术切缘不足（p=0.0151 和 p=0.0055）是所有远处转移和肺转移不良预后的显著预测因素。然而，只有年龄较小（p=0.0148）是早期转移（6 个月内）的唯一危险因素。
STS 患者原发性肿瘤切除后早期远处转移的唯一危险因素是年龄较小，尽管大肿瘤直径和组织学高级别是远处转移的危险因素。
