小肠和大肠的肌肉瘤：一项临床病理研究

Myosarcomas of the small and large intestine: a clinicopathologic study.

作者信息

Shiu M H, Farr G H, Egeli R A, Quan S H, Hajdu S I

出版信息

J Surg Oncol. 1983 Sep;24(1):67-72. doi: 10.1002/jso.2930240116.

Abstract

A retrospective study was made of 38 myosarcomas of the small and large intestines (34 leiomyosarcomas and 4 malignant leiomyoblastomas). Endoenteric, small, and noninvasive tumors were successfully treated by simple wedge excision, cautery snare removal, or segmental bowel resection with a high 5-yr cure rate of 86% (12/14). Exo-enteric tumors often invaded adjacent structures or perforated into the peritoneal cavity. Extensive resection procedures, including pancreaticoduodenectomy, abdominoperineal resection, and pelvic exenteration salvaged only 13% (2/16) of these patients. Three clinicopathologic factors adversely affected prognosis: i) tumor size greater than 5 cm in diameter, ii) extra-intestinal invasion or free perforation, and iii) high histopathologic grade of malignancy. The presence of none, one, two, or three of these adverse factors gave decreasing 5-yr survival rates of 100, 44, 31, and 0%, respectively. These observations suggest use of a multimodal treatment program that may minimize treatment failure from local as well as distant disease.

摘要

对38例小肠和大肠肌肉瘤（34例平滑肌肉瘤和4例恶性平滑肌瘤）进行了回顾性研究。肠内、小的和非侵袭性肿瘤通过简单楔形切除术、电灼圈套切除术或肠段切除术成功治疗，5年治愈率高达86%（14例中的12例）。肠外肿瘤常侵犯相邻结构或穿入腹腔。广泛的切除手术，包括胰十二指肠切除术、腹会阴切除术和盆腔脏器清除术，仅使这些患者中的13%（16例中的2例）获救。三个临床病理因素对预后产生不利影响：i）肿瘤直径大于5 cm，ii）肠外侵犯或游离穿孔，iii）高组织病理学恶性分级。这些不利因素不存在、存在一个、存在两个或存在三个时，5年生存率分别为100%、44%、31%和0%。这些观察结果提示应采用多模式治疗方案，该方案可使局部和远处疾病导致的治疗失败降至最低。