Garg Lokesh, Pruthi Manish, Batra Ullas, Doval D C, Pasricha Sunil, Jaipuria Jiten, Virk Jagandeep Singh, Tiwari Akshay
Musculoskeletal Oncology, Dharamshila Narayana Superspecialty Hospital, New Delhi, India.
Tata Memorial Hospital, Mumbai, Maharastra India.
Indian J Surg Oncol. 2022 Sep;13(3):518-524. doi: 10.1007/s13193-022-01510-0. Epub 2022 Feb 10.
The aim of this study was to evaluate the outcome of patients with soft tissue sarcoma of the extremity and abdominal wall. This is the retrospective analysis of patients from a prospectively maintained data base from a single institute. We identified 79 patients with intermediate- to high-grade soft tissue sarcomas who were treated at our institute between Jan 2015 and July 2018. Low-grade tumors were excluded. There were 60 males and 19 females with a mean age of 44.6 years. Of the 79 sarcomas, 50 were in the lower limb and 24 in the upper limb and 5 were in abdominal wall. The commonest subtypes were undifferentiated pleomorphic sarcoma ( = 21) and synovial sarcoma ( = 19). Only 9 patients had metastatic disease at presentation. All 79 patients underwent surgical resection with an intent to achieve clear margins. Amputation was done in 19 patients while wide excision of the tumor was done in 60 patients. Adjuvant radiotherapy was given in 49 patients while adjuvant chemotherapy was given in 35 patients. At last follow-up (73 patients), 48 patients are alive without disease, 9 are alive with disease, 12 patients had died of disease, and 4 patients died due to other causes. Overall survival (OS) for 3 year is 77.6%, and estimated mean survival is 55.05 months. Relapse-free surviva (RFS)l at 3 year is 74.3%, and estimated mean RFS is 51.78. The only independent factor that affected the OS was the dimension of primary tumor ( = 0.02). For disease-free survival, the independent factors that affected outcome were stage at presentation ( = 0.04) and dimension of the tumor ( = 0.04). Short-term results shown by this study shows good outcome in patient with intermediate- to high-grade sarcomas when multidisciplinary approach is utilized for the management. Patients who had metastatic disease at presentation did worse than patients who did not.
本研究的目的是评估四肢和腹壁软组织肉瘤患者的治疗结果。这是一项对来自单一机构前瞻性维护数据库的患者进行的回顾性分析。我们确定了79例2015年1月至2018年7月在我院接受治疗的中高级别软组织肉瘤患者。低级别肿瘤被排除在外。其中男性60例,女性19例,平均年龄44.6岁。79例肉瘤中,50例位于下肢,24例位于上肢,5例位于腹壁。最常见的亚型是未分化多形性肉瘤(21例)和滑膜肉瘤(19例)。仅9例患者初诊时即有转移性疾病。所有79例患者均接受了手术切除,目的是实现切缘阴性。19例患者行截肢术,60例患者行肿瘤广泛切除术。49例患者接受了辅助放疗,35例患者接受了辅助化疗。在最后一次随访时(73例患者),48例患者无病存活,9例患者带瘤存活,12例患者死于疾病,4例患者死于其他原因。3年总生存率(OS)为77.6%,估计平均生存期为55.05个月。3年无复发生存率(RFS)为74.3%,估计平均无复发生存期为51.78个月。影响总生存率的唯一独立因素是原发肿瘤大小(P = 0.02)。对于无病生存,影响预后的独立因素是初诊时的分期(P = 0.04)和肿瘤大小(P = 0.04)。本研究显示的短期结果表明,对于中高级别肉瘤患者,采用多学科方法进行治疗可取得良好的治疗效果。初诊时即有转移性疾病的患者比没有转移性疾病的患者预后更差。