Soft tissue sarcoma : epidemiology and prognosis in 508 patients
Soft tissue sarcoma : epidemiology and prognosis in 508 patients
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软组织肉瘤：508例患者的流行病学和预后
DOI：
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
P. Gustafson
中科院分区：
文献类型：
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作者：
P. Gustafson
我们评估了一系列四肢和躯干壁软组织肉瘤（STS）成人患者的流行病学、预后以及转移和局部复发之间的关系。从1964年到1989年，瑞典南部卫生保健区诊断出508例患者。该系列以人口为基础，即，在一个确定的区域内的所有病人都包括在内，而不论在哪里接受治疗，从而避免了转诊和随访中的选择偏差。流行病学。年发病率为18/100万。中位年龄为64岁。三分之一的肿瘤是皮下的，这些肿瘤比深层肿瘤小。恶性纤维组织细胞瘤和IV级是最常见的。不同组织类型间的临床病理特征存在差异。5年无转移生存率（MFSR）为0.6。粗局部复发率为0.3。大多数转移和局部复发发生在3年内。随着时间的推移，肿瘤中心的转诊模式变得更加有利;在过去5年中，一半的皮下肿瘤和五分之四的深部肿瘤在手术前转诊。预后因素。在组织学混合系列中，肿瘤大小、肿瘤坏死和血管侵袭是转移的强有力且独立的预后因素。在MFH中，故事状和多形性亚型，肿瘤坏死和肿瘤大小与预后不良相关。肿瘤坏死和血管侵犯独立恶化平滑肌肉瘤的预后。在脂肪肉瘤、肿瘤坏死和滑膜肉瘤中，肿瘤大小是唯一重要的预后因素。肿瘤大小、肿瘤坏死和血管浸润被用于一个预后系统，该系统确定了三分之二的患者5年MFSR为0.8，三分之一的患者5年MFSR为0.3。转移和局部复发。应谨慎解释局部复发和转移的因果关系。我们认为高度恶性肿瘤结合了联合收割机的局部和远处侵袭性，局部复发是转移风险的标志，而不一定是转移的原因。结论. 1.在研究软组织肉瘤的流行病学时，以人群为基础的系列研究是优选的。2.我们认为肿瘤大小、肿瘤坏死和血管浸润是提高预后准确性的重要因素。3.有越来越多的证据反对局部复发和转移之间的因果关系。
We have evaluated epidemiology, prognosis and the association between metastases and local recurrence in a series of adult patients with soft tissue sarcoma (STS) of the extremity and trunk wall. 508 patients were diagnosed in the Southern Swedish Health Care Region from 1964 through 1989. The series was population-based, i.e., all patients within a defined area were included, irrespective of where treated, thereby avoiding selection bias in referral and follow-up. Epidemiology. The annual incidence was 18 per million. The median age was 64 years. One third of the tumors were subcutaneous, and these were smaller than the deep-seated tumors. Malignant fibrous histiocytoma and grade IV were the commonest. Differences were noted in clinicopathologic features among histotypes. The 5-year metastasis-free survival rate (MFSR) was 0.6. The crude local recurrence rate was 0.3. The majority of metastases and local recurrences occurred within 3 years. The referral pattern to the tumor center has become more favorable over time; in the last 5 years half of the subcutaneous and four fifths of the deep-seated tumors were referred before surgery. Prognostic factors. Tumor size, tumor necrosis, and vascular invasion were strong and independent prognostic factors for metastasis in a histologically mixed series. In MFH, storiform and pleomorphic subtype, tumor necrosis and tumor size were associated with a poor prognosis. Tumor necrosis and vascular invasion independently worsened the prognosis in leiomyosarcoma. In liposarcoma, tumor necrosis and in synovial sarcoma, tumor size were the only important prognostic factors. Tumor size, tumor necrosis, and vascular invasion were used in a prognostic system which identified two thirds of all patients with a 5-year MFSR of 0.8 and one third of the patients with a 5-year MFSR of 0.3. Metastasis and local recurrence. The causal association proposed for local recurrence and metastasis should be interpreted with caution. We suggest that highly malignant tumors combine local and distant aggressiveness, and that local recurrence is a marker of risk, and not necessarily a cause of, metastasis. Conclusions. 1. Population-based series are preferable when studying epidemiology in soft tissue sarcoma. 2. We propose that tumor size, tumor necrosis, and vascular invasion are strong and reliable factors that can be used to improve prognostic accuracy. 3. There is a growing body of evidence against a causal relationship between local recurrence and metastasis.
成人四肢软组织肉瘤截肢的作用不断变化。
DOI：
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发表时间：
1992
期刊：
Surgery, gynecology & obstetrics
影响因子：
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作者：
Williard,WC;Collin,C;Casper,ES;Hajdu,SI;Brennan,MF
通讯作者：
Brennan,MF
改善局部控制对软组织肉瘤患者生存的影响。
DOI：
10.1016/0360-3016(86)90083-0
发表时间：
1986
期刊：
International journal of radiation oncology, biology, physics
影响因子：
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作者：
Suit,HD;Tepper,JE
通讯作者：
Tepper,JE