Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Okayama City, Okayama, 700-8558, Japan.
J Orthop Surg Res. 2023 Aug 14;18(1):599. doi: 10.1186/s13018-023-04088-7.
Soft tissue sarcomas (STS) of the forearm are rare. We aim to assess their oncological and functional outcomes.
We retrospectively evaluated 34 patients who underwent surgical excision for forearm STS at our institution between 1993 and 2020. We analyzed postoperative Musculoskeletal Tumor Society rating scale (MSTS) and local recurrence-free survival (LRFS), metastasis-free survival, and overall survival (OS) rates. The significance of the following variables was determined: age, sex, histology, tumor size, Fédération Nationale des Centres de Lutte contre le Cancer grade, American Joint Committee on Cancer stage, surgical margin, unplanned excision, metastases upon initial presentation, receipt of chemotherapy, and radiotherapy (RT).
The postoperative median MSTS score was 28. Bone resection or major nerve palsy was the only factor that influenced MSTS scores. The median MSTS scores in patients with or without bone resection or major nerve palsy were 24 and 29, respectively (P < 0.001). The 5-year LRFS rates was 87%. Univariate analysis revealed that the histological diagnosis of myxofibrosarcoma was the only factor that influenced LRFS (P = 0.047). The 5-year MFS rates was 71%. In univariate analysis, no factors were associated with MFS. The 5-year OS rates was 79%. Age was the only factor that influenced OS (P = 0.01).
In the treatment of forearm STS, reconstruction of the skin and tendon can compensate for function, while bone resection and major nerve disturbance cannot. Careful follow-up is important, especially in patients with myxofibrosarcoma, due to its likelihood of local recurrence.
前臂软组织肉瘤（STS）较为罕见。我们旨在评估其肿瘤学和功能预后。
我们回顾性评估了 1993 年至 2020 年期间在我院接受手术切除的 34 例前臂 STS 患者。我们分析了术后肌肉骨骼肿瘤学会评分量表（MSTS）和局部无复发生存率（LRFS）、无转移生存、总生存（OS）率。以下变量的意义：年龄、性别、组织学、肿瘤大小、法国抗癌联合会分级、美国癌症联合委员会分期、手术切缘、计划外切除、初始表现时转移、接受化疗、放疗（RT）。
术后中位 MSTS 评分为 28 分。骨切除或主要神经麻痹是唯一影响 MSTS 评分的因素。无骨切除或主要神经麻痹患者的中位 MSTS 评分为 24 和 29（P<0.001）。5 年 LRFS 率为 87%。单因素分析显示，黏液纤维肉瘤的组织学诊断是影响 LRFS 的唯一因素（P=0.047）。5 年 MFS 率为 71%。单因素分析显示，无因素与 MFS 相关。5 年 OS 率为 79%。年龄是唯一影响 OS 的因素（P=0.01）。
在治疗前臂 STS 时，皮肤和肌腱的重建可以弥补功能，而骨切除和主要神经干扰则不能。由于黏液纤维肉瘤局部复发的可能性较大，因此仔细随访非常重要。
