Van Geel A N, Van Unnik J A, Keus R B
Dr. Daniel den Hoed Kliniek, afd. Chirurgische Oncologie, Rotterdam.
Ned Tijdschr Geneeskd. 1995 Apr 22;139(16):833-7.
Soft-tissue sarcomas constitute a rare group of malignant tumours with histopathological features of connective, muscular, fatty or peripheral nervous tissue. The prognosis at manifestation depends on only two factors: the spread, both local and remote, and the biological behaviour of the tumour. The latter factor cannot be influenced but the former can: by inexpert manipulation. Consequently, tumours suspected of being soft-tissue sarcomas require multidisciplinary management from the beginning, with the team members familiar with each other's diagnostic and therapeutic skills. Imaging diagnostic methods should precede invasive methods for collection of material for pathological examination. The number of mitotic figures observed at microscopical examination of the tissue is an important prognostic feature. Surgical resection is the treatment of first choice. Radiotherapy is indicated in grade 3 tumours, after recurrence surgery, and when radical resection would involve too much mutilation. Chemotherapy is only given in the context of clinical trials. Surgical treatment of lung metastases may be indicated in selected patients. Regional isolated perfusion with tumour necrosis factor may be an alternative for limb amputation.
软组织肉瘤是一类罕见的恶性肿瘤，具有结缔组织、肌肉组织、脂肪组织或周围神经组织的组织病理学特征。发病时的预后仅取决于两个因素：肿瘤的局部和远处扩散以及生物学行为。后一个因素无法改变，但前一个因素可以：因操作不熟练而改变。因此，疑似软组织肉瘤的肿瘤从一开始就需要多学科管理，团队成员要熟悉彼此的诊断和治疗技能。影像学诊断方法应先于用于获取病理检查材料的侵入性方法。组织显微镜检查中观察到的有丝分裂象数量是一个重要的预后特征。手术切除是首选治疗方法。三级肿瘤、复发手术后以及根治性切除会导致过多致残时，需进行放射治疗。化疗仅在临床试验的情况下使用。部分患者可能需要对肺转移灶进行手术治疗。肿瘤坏死因子区域隔离灌注可能是肢体截肢的替代方法。
