四肢软组织肉瘤26例临床分析

Clinical analysis of 26 cases of soft tissue sarcoma in extremities

目的 探讨四肢软组织肉瘤疗效与肿瘤分期、手术方法的关系。方法 对 2 6例不同病期四肢软组织肉瘤患者行局部广泛切除 (18例 )和截肢 (8例 )术。结果 18例局部广泛切除术中 ,Ⅰ期 14例 ,其中 11例术后存活 5～ 19年无复发转移 ,3例局部复发 ;Ⅲ期、Ⅳa 期 4例术后均发生局部复发转移。 8例截肢术中 ,3例术后 1年 6个月肺转移死亡 ,5例术后存活 4～ 18年无复发转移。结论 Ⅰ期肉瘤局部广泛切除术后疗效较好 ,Ⅲ期、Ⅳa 期局部广泛切除术后疗效不佳 ,宜作一期手术截肢。手术切除应彻底 。

Objective To study the relationship of surgical treatment, pathological stage and prognosis of soft tissue sarcoma in extremities. Methods 26 cases of soft tissue sarcoma in extremities in different pathological stages were reviewed. 18 cases were treated with wide excision and 8 cases with amputation. Results Among 18 cases treated with wide excision, 14 cases were patients in grade Ⅰ , 11 cases survived for 5 to 19 years without relapse and 3 cases had local recurrence. In 8 patients treated with amputation, 3 died of lung metastases within 18 months, 5 cases survived for 4～8 years without relapse. Conclusion The prognosis of sarcoma in grade Ⅰ excision is better than in grade Ⅲ or Ⅳ a if treated with wide excision. For grade Ⅲ or Ⅳ a patients, amputation or disarticulation is recommended. The extent of local resection should be wide enough or radical, and adjuvant radiotherapy is advisable.