Oncological Outcomes of Operative Treatment of Subcutaneous Soft-Tissue Sarcomas of the Extremities*

作者：C. Parker Gibbs, Terrance D. Peabody, Arno James Mundt, ANTHONY G. MONTAG, Michael A. Simon · 发表于：Journal of Bone and Joint Surgery · 年份：1997 · DOI：10.2106/00004623-199706000-00013 · 被引用次数：67 · 研究领域：Sarcoma Diagnosis and Treatment、Vascular Tumors and Angiosarcomas、Soft tissue tumors and treatment

We reviewed the cases of sixty-two patients who had had a subcutaneous sarcoma to determine the effect of tumor and treatment-related variables on the rates of survival and local recurrence. Fifty-nine (95 per cent) of the patients had had an operation at another hospital before being referred to us. Twenty-nine (47 per cent) of the sixty-two tumors were high-grade, forty-two (68 per cent) were small (five centimeters or less), and thirty (48 per cent) were malignant fibrous histiocytomas. We followed a treatment strategy that consisted of repeat excision with the goal of obtaining wide margins. Excluding thirteen patients who had had a palpable local recurrence at the time of presentation, twenty (49 per cent) of forty-one patients who had had a marginal excision at another hospital had microscopic residual tumor on repeat excision. At a median of fifty-six months after the repeat excision, fifty (81 per cent) of the sixty-two patients had been continuously disease-free, one had no evidence of disease, eight had died of the disease, and three had died of other causes. The five-year rate of disease-free survival was 85 per cent (fifty-three of sixty-two patients). There were three local recurrences, all in patients who had had a marginal resection. No recurrences were noted in patients who had had a wide local excision of the tumor or of the previous operative field. Multivariate analysis revealed that a large tumor (greater than five centimeters), a marginal excision, and ad...