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肿瘤局部复发与生存的关系是当今肿瘤外科领域中最有争议的一个问题。头颈部及盆腔的癌肿局部复发致使局部重要结构受累,因而对生存有明显的影响。而乳癌、恶性黑色素瘤或四肢的恶性肿瘤,局部复发甚少产生致命性的后果,若其使远处转移的机率增加,则可影响生存。这一问题具有重要的临床意义,对处理四肢软组织肉瘤尤为如此。以保留肢体的联合方式治疗四肢软组织肉瘤与一期截肢相比,前者似与较高的局部复发率有关。许多作者认为发生局部复发的病人,远处转移和死亡的危险性增加。另有人认为全身性病变的出现并非取决于局部复发。而且局部病变常能获得令人满意的治疗结果,故对生存并不影响。
The relationship between local tumor recurrence and survival is the most controversial issue in the field of oncology surgery today. The local recurrence of cancer in the head and neck and pelvic region causes local important structures to be involved and thus has a significant impact on survival. In breast cancer, malignant melanoma, or malignant tumors of the extremities, local recurrence rarely produces fatal consequences. If it increases the chance of distant metastasis, it can affect survival. This problem has important clinical significance, especially for the treatment of limb soft tissue sarcoma. Treatment of extremities with soft tissue sarcoma in a joint limb-preserving manner was associated with a higher rate of local recurrence compared with the first-stage amputation. Many authors believe that patients with local recurrences have an increased risk of distant metastases and death. Others believe that the appearance of systemic lesions does not depend on local recurrence. And local lesions can often obtain satisfactory treatment results, so it does not affect survival.