Muramatsu Shudai, Kobayashi Eisuke, Toda Yu, Iwata Shintaro, Ogura Koichi, Osaki Shuhei, Fukushima Suguru, Kawai Akira
Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Centre Hospital, Tokyo 104-0045, Japan.
Department of Orthopaedic Surgery, Kochi Medical School, Kochi 783-8505, Japan.
Mol Clin Oncol. 2025 Jul 22;23(4):88. doi: 10.3892/mco.2025.2883. eCollection 2025 Oct.
Hand sarcomas are very rare, and few studies have focused on their anatomical distribution, such as involvement of the fingers vs. the palm/dorsum (PD). The present study reviewed 24 cases of hand sarcomas identified from medical records of National Cancer Centre Hospital (Tokyo, Japan) between January 2010 and December 2022, examining sex, age, maximum tumour size, metastasis, histology, origin (bone vs. soft tissue), pain, biopsy performance, unplanned excision at previous institutes, treatment (surgery including reconstructive procedures, chemotherapy, and radiotherapy) and prognosis. The patients were divided into two groups, finger and PD, to facilitate comparison. Among the 24 cases, 9 occurred in the fingers and 15 occurred in the PD. Soft tissue was involved in 21 cases, while 3 cases arose from the bone, all in the fingers. Pain was present in 11 cases, with 6 cases (33%) in the fingers and 5 cases (66%) in the PD group. Synovial sarcoma, the most common histological subtype among the series, occurred exclusively in the PD group (n=7). In the finger group, 9 patients were managed with amputation, and only one received adjuvant therapy. In contrast, 10 of the 15 PD sarcomas underwent wide resection with reconstruction, and 6 received chemo- or radiotherapy. Overall, hand sarcomas had a favourable prognosis, with 86% overall survival and 77% disease-free survival rates; however, pleomorphic spindle cell sarcoma exhibited an exceptionally poor prognosis. In conclusion, synovial sarcoma was more prevalent in the PD region and finger sarcomas exhibited a slight tendency to cause pain. Treatment strategies varied significantly between the finger and PD groups.
手部肉瘤非常罕见，很少有研究关注其解剖分布，例如手指受累与手掌/手背（PD）受累情况。本研究回顾了2010年1月至2022年12月期间从日本东京国立癌症中心医院的病历中识别出的24例手部肉瘤病例，检查了性别、年龄、最大肿瘤大小、转移情况、组织学、起源（骨与软组织）、疼痛、活检情况、之前机构的意外切除情况、治疗（包括重建手术、化疗和放疗）及预后。为便于比较，将患者分为手指组和PD组。在这24例病例中，9例发生在手指，15例发生在PD部位。21例累及软组织，3例起源于骨，均在手指。11例有疼痛，其中手指组6例（33%），PD组5例（66%）。滑膜肉瘤是该系列中最常见的组织学亚型，仅发生在PD组（n = 7）。在手指组，9例患者接受了截肢手术，只有1例接受了辅助治疗。相比之下，15例PD肉瘤中有10例行广泛切除并重建，6例接受了化疗或放疗。总体而言，手部肉瘤预后良好，总生存率为86%，无病生存率为77%；然而，多形性梭形细胞肉瘤预后极差。总之，滑膜肉瘤在PD区域更常见，手指肉瘤有轻微的疼痛倾向。手指组和PD组的治疗策略差异显著。
