软组织肉瘤患者接受非计划性切除的预后因素详细分析。

Detailed Analysis of Prognostic Factors in Patients with Soft Tissue Sarcoma Undergoing Unplanned Excision.

作者信息

Tsuchie Hiroyuki, Emori Makoto, Murahashi Yasutaka, Mizushima Emi, Shimizu Junya, Nagasawa Hiroyuki, Miyakoshi Naohisa, Murata Shohei, Teramoto Atsushi

机构信息

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.

Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.

出版信息

Med Princ Pract. 2025 Jul 11:1-9. doi: 10.1159/000547333.

DOI:10.1159/000547333

PMID:40652919

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12503512/

Abstract

OBJECTIVES

Unplanned excision (UE) of soft tissue sarcoma (STS) impacts recurrence and prognosis, influenced by various factors. However, few studies have thoroughly analyzed these patients. This study aimed to comprehensively evaluate prognostic factors in patients with STS who underwent UE.

SUBJECT AND METHODS

We retrospectively identified 62 patients with STS who underwent UE. Data on clinical information and detailed assessment were collected. Clinical data were evaluated as risk factors for overall survival, local recurrence, and distant metastases. Furthermore, associations of influencing factors and survival outcomes were analyzed.

RESULTS

Multivariate analysis identified consultation after local recurrence following previous surgery and histological high grade as significant predictors of poor prognosis (p = 0.0390 and p = 0.0282, respectively). Histological high grade was the only risk factor for distant metastasis (p = 0.0173). Kaplan-Meier curves demonstrated significant differences in overall survival based on the presence or absence of local recurrence at referral after UE (p = 0.0476, p = 0.0022). The use of local anesthetics in previous surgeries was the only risk factor for consultation after local recurrence.

CONCLUSION

Referral after local recurrence after UE and histological high grade were poor prognostic factors. Physicians must be aware that patients with UE should be referred to specialists promptly.

摘要

目的

软组织肉瘤（STS）的意外切除（UE）会影响复发和预后，受多种因素影响。然而，很少有研究对这些患者进行全面分析。本研究旨在全面评估接受UE的STS患者的预后因素。

对象与方法

我们回顾性纳入了62例接受UE的STS患者。收集临床信息和详细评估数据。将临床数据评估为总生存、局部复发和远处转移的危险因素。此外，分析影响因素与生存结果之间的关联。

结果

多因素分析确定，既往手术后局部复发后的会诊以及组织学高级别是预后不良的显著预测因素（分别为p = 0.0390和p = 0.0282）。组织学高级别是远处转移的唯一危险因素（p = 0.0173）。Kaplan-Meier曲线显示，基于UE后转诊时是否存在局部复发，总生存存在显著差异（p = 0.0476，p = 0.0022）。既往手术中使用局部麻醉剂是局部复发后会诊的唯一危险因素。