Gustafson P, Rydholm A, Willén H, Baldetorp B, Fernö M, Akerman M
Department of Orthopedics, University Hospital, Lund, Sweden.
Int J Cancer. 1993 Oct 21;55(4):541-6. doi: 10.1002/ijc.2910550404.
Different conceptions exist regarding the epidemiology and prognosis of liposarcoma, and several classification systems are in use. We analyzed a population-based, 25-year series of 43 patients with liposarcoma of the extremity or trunk wall. Follow-up was complete. The annual incidence was 0.12/10(5). The thigh was the most common location. One of 6 tumors was subcutaneous. Deep-seated tumors were larger than s.c. tumors. Among the 42 surgically treated patients, grade II (4-grade scale) was the most common malignancy grade. Four tumors were well-differentiated, 24 were predominantly myxoid, 4 predominantly round-cell, and 10 were predominantly of pleomorphic type. The 5-year metastasis-free survival rate was 69%. By univariate analysis increasing malignancy grade, tumor necrosis, vascular invasion, mitotic count, subtype other than well-differentiated, and high cellularity were prognostic for metastatic disease. However, in the multivariate analysis only tumor necrosis was an independent risk factor. Tumor necrosis should be considered when prognosis of liposarcoma of the extremity and trunk wall is evaluated.
关于脂肪肉瘤的流行病学和预后存在不同的概念,并且有几种分类系统正在使用。我们分析了一项基于人群的、为期25年的43例肢体或躯干壁脂肪肉瘤患者的系列研究。随访完整。年发病率为0.12/10(5)。大腿是最常见的部位。6个肿瘤中有1个是皮下的。深部肿瘤比皮下肿瘤大。在42例接受手术治疗的患者中,II级(4级评分)是最常见的恶性等级。4个肿瘤为高分化,24个主要为黏液样,4个主要为圆形细胞,10个主要为多形性类型。5年无转移生存率为69%。单因素分析显示,恶性等级增加、肿瘤坏死、血管侵犯、有丝分裂计数、非高分化亚型以及高细胞密度是转移疾病的预后因素。然而,多因素分析显示只有肿瘤坏死是独立的危险因素。在评估肢体和躯干壁脂肪肉瘤的预后时应考虑肿瘤坏死。