Peiper M, Zurakowski D, Zornig C
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Langenbecks Arch Chir. 1995;380(6):333-9. doi: 10.1007/BF00207221.
Soft tissue sarcomas (STS) tend to recur locally. In a series of 140 patients operated on during the past two decades with STS of the extremities and trunk, prognostic factors influencing local recurrence were determined. Statistical significance was evaluated for the quality of surgical resection (P < 0.001), regional positive lymph nodes (P = 0.03), and adjuvant radiotherapy (P = 0.01) [for resection without wide margins (R1) and low-grade (G3) tumors]. In 1988, the surgical procedure was standardized. After 1987, local recurrence decreased significantly (P < 0.001). In subfascial tumors, local recurrence occurred far less in cases of compartmental resection than with wide excision. These data indicate that the course of patients with STS can be beneficially influenced by optimal therapy. Resection with wide margins in all three dimensions is the aim of sarcoma surgery. Postoperative radiation therapy is indicated in the case of R1 resection.
软组织肉瘤(STS)往往会局部复发。在过去二十年中对140例接受四肢和躯干STS手术的患者进行了研究,确定了影响局部复发的预后因素。对手术切除质量(P < 0.001)、区域淋巴结阳性(P = 0.03)和辅助放疗(P = 0.01)[针对切缘不宽(R1)和低级别(G3)肿瘤]进行了统计学显著性评估。1988年,手术程序实现了标准化。1987年之后,局部复发显著减少(P < 0.001)。在筋膜下肿瘤中,与广泛切除相比,间室切除病例的局部复发要少得多。这些数据表明,最佳治疗可对STS患者的病程产生有益影响。三维切缘宽阔的切除是肉瘤手术的目标。R1切除的情况下需进行术后放疗。