Rydholm A, Rööser B, Persson B M
J Bone Joint Surg Am. 1986 Apr;68(4):586-9.
Sixteen patients with an intramuscular or intermuscular high-grade Stage-IIA soft-tissue sarcoma in the upper or lower extremity were treated by en bloc myectomy of one or several muscles without preoperative or intraoperative open biopsy. The total anatomical compartment containing the tumor, bounded by deep fascia and major intermuscular septa, as defined by the Musculoskeletal Tumor Society, was not removed. Adjunctive therapy was not given. The clinical and radiographic diagnosis of sarcoma was supported by the study of cells obtained by fine-needle aspiration in eleven patients. During a median length of follow-up of seven years (range, one to fourteen years), there was only one local recurrence. Thus, it is our experience that, in addition to deep fascia and major intermuscular septa, an uninvolved muscle fascia that has not been transgressed by an open biopsy is an adequate barrier against tumor growth or so-called skip metastases, and that with the proper indications total compartmental resection is not necessary even for a high-grade sarcoma.
16例上肢或下肢肌内或肌间ⅡA期高级别软组织肉瘤患者，接受了整块切除一块或几块肌肉的手术，术前及术中均未进行开放活检。未切除由深筋膜和主要肌间隔界定的、包含肿瘤的整个解剖学间隔，这是根据肌肉骨骼肿瘤学会的定义。未给予辅助治疗。11例患者通过细针穿刺获取的细胞研究支持了肉瘤的临床和影像学诊断。在中位随访7年（范围1至14年）期间，仅出现1例局部复发。因此，根据我们的经验，除了深筋膜和主要肌间隔外，未被开放活检侵犯的未受累肌筋膜是防止肿瘤生长或所谓跳跃转移的充分屏障，并且在有适当指征时，即使对于高级别肉瘤也无需进行全间隔切除。
