Zanarini D, Sugarbaker P H
Washington Cancer Institute, Washington Hospital Center, DC, USA.
J Surg Oncol. 1997 Jan;64(1):68-72; discussion 72-3. doi: 10.1002/(sici)1096-9098(199701)64:1<68::aid-jso13>3.0.co;2-s.
In a majority of patients with extremity soft tissue sarcoma, the lungs are the first site at which recurrent disease is detected. Other common sites of recurrence are the resection site, bone metastasis, and liver metastasis. Although abdomino pelvic sarcomatosis is common as a site of recurrence for visceral and retroperitoneal sarcoma, it has not been previously reported for extremity sarcoma.
We present three patients in whom extremity soft tissue sarcoma metastasized to the peritoneal surfaces, and in all three patients this was symptomatically the dominant site for recurrence. All of them underwent a palliative surgical cytoreduction and were then treated with intraperitoneal chemotherapy.
In two of the three patients, isolated progression of peritoneal sarcomatosis has again occurred: one patient remains disease free at 14 months.
Metastasis to peritoneal surfaces within the abdomen and pelvis must be considered a possible site for systemic dissemination of extremity soft tissue sarcomas. Effective treatments for sarcoma spread to peritoneal surfaces would benefit this small but symptomatic group of patients.
在大多数肢体软组织肉瘤患者中,肺部是首次检测到复发性疾病的部位。其他常见的复发部位是切除部位、骨转移和肝转移。尽管腹盆腔肉瘤病作为内脏和腹膜后肉瘤的复发部位很常见,但此前尚未见肢体肉瘤的相关报道。
我们报告了3例肢体软组织肉瘤转移至腹膜表面的患者,在所有这3例患者中,腹膜表面均为有症状的主要复发部位。他们均接受了姑息性手术减瘤,随后接受了腹腔内化疗。
3例患者中有2例再次出现孤立性腹膜肉瘤病进展:1例患者在14个月时仍无疾病。
必须考虑肢体软组织肉瘤向腹盆腔腹膜表面转移是全身播散的一个可能部位。有效治疗肉瘤扩散至腹膜表面将使这一小部分有症状的患者受益。