Ueda T, Yoshikawa H, Mori S, Araki N, Myoui A, Kuratsu S, Uchida A
Department of Orthopaedic Surgery, Osaka Medical Centre for Cancer and Cardiovascular Diseases and Osaka University Medical School, Japan.
J Bone Joint Surg Br. 1997 Jul;79(4):553-7. doi: 10.1302/0301-620x.79b4.7487.
We have investigated the significance of local recurrence on survival in 173 patients with localised soft-tissue sarcomas of the limbs and of the trunk. The overall survival rates at five and ten years were 75.2% and 68.0%, respectively. After definitive surgery at our hospitals, there was local recurrence in 25 patients (14.5%). After inadequate operations elsewhere, there was a higher incidence of late local recurrence (28.3%), in comparison with those with primary tumours treated by us (9.0%), or patients referred to us immediately after inadequate surgery elsewhere (10.2%). Because of small numbers these differences in the survival rates were not statistically significantly different. Univariate survival analysis showed that local recurrence after definitive surgery (p = 0.006) together with the histological grade (p = 0.0002), the size of the tumour (p = 0.002), its depth in relation to deep fascia (p = 0.003), and the surgical margin (p = 0.0001) were the significant prognostic factors. Local recurrence at the initial presentation did not affect survival. Multivariate analysis showed that local recurrence after definitive surgery also lost its apparent prognostic significance.
我们研究了173例肢体和躯干局限性软组织肉瘤患者局部复发对生存的意义。五年和十年的总生存率分别为75.2%和68.0%。在我们医院进行根治性手术后，25例患者（14.5%）出现局部复发。在其他地方接受不充分手术的患者中，局部复发的发生率较高（28.3%），与我们治疗的原发性肿瘤患者（9.0%）或在其他地方接受不充分手术后立即转诊至我们这里的患者（10.2%）相比。由于样本量较小，这些生存率差异无统计学意义。单因素生存分析表明，根治性手术后的局部复发（p = 0.006）以及组织学分级（p = 0.0002）、肿瘤大小（p = 0.002）、其相对于深筋膜的深度（p = 0.003）和手术切缘（p = 0.0001）是显著的预后因素。初次就诊时的局部复发不影响生存。多因素分析表明，根治性手术后的局部复发也失去了其明显的预后意义。
