论文部分内容阅读
目的:分析导致软组织肉瘤非计划切除的原因并探讨避免软组织肉瘤非计划切除的策略。方法:自2009年10月至2012年12月新疆医科大学第一附属医院骨科中心骨病骨肿瘤科收治的105例软组织肉瘤患者资料,其中男性65例,女性40例,平均年龄52岁;接受计划性软组织肉瘤切除术患者82例(计划手术组),曾于外院接受非计划切除术的软组织肉瘤患者23例(非计划手术组)。计划手术组患者行广泛切除及根治切除术,非计划手术组患者行扩大切除术。统计分析两组患者一般情况、病灶位置及大小、手术边界、肿瘤复发转移情况,并比较两组患者生存期。结果:非计划手术组达到广泛切除边界的比例明显低于计划手术组(P<0.05)。非计划手术组患者3年生存率明显低于计划手术组(P=0.001)。非计划手术组平均随访18个月(3~36个月),12例死亡(52.2%),其中9例(39.1%)死于肿瘤转移,3例死于其他疾病;计划手术组平均随访23个月(5~36个月),15例(18.3%)死亡,其中12例(14.6%)死于肿瘤转移,3例死于其他疾病。结论:与计划手术相比,软组织肉瘤非计划切除常导致手术范围不足、肿瘤复发转移的风险,可能增高肿瘤所致的死亡率。临床医生应尽量避免非计划切除手术的发生。
OBJECTIVE: To analyze the causes of unscheduled resections of soft tissue sarcomas and to explore strategies to avoid unscheduled resections of soft tissue sarcomas. Methods: From October 2009 to December 2012, the data of 105 patients with soft tissue sarcoma admitted to the Department of Orthopedic Orthopedics and Oncology, the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. Among them, 65 were males and 40 were females with an average age of 52 years. Totally, 82 patients undergoing planned soft tissue sarcoma resection (planned surgery group) and 23 patients with unspecified soft tissue sarcoma (unplanned surgery group) underwent external surgery. Patients in the planned surgery group underwent extensive resection and radical resection, and patients in the unplanned surgery group underwent extensive resection. Statistical analysis of two groups of patients in general, lesion size and location, surgical boundaries, tumor recurrence and metastasis, and compared the survival of patients in both groups. Results: The proportion of patients who underwent extensive resection in the unplanned surgery group was significantly lower than that in the planned surgery group (P <0.05). Patients in the unplanned surgery group had a significantly lower 3-year survival rate than the planned surgery group (P = 0.001). In the unplanned surgery group, the mean follow-up was 18 months (range 3 to 36 months) and 12 deaths (52.2%), of which 9 (39.1%) died of tumor metastasis and 3 died of other diseases. The average follow-up of planned surgery group was 23 (5 to 36 months) and 15 (18.3%) died, of which 12 (14.6%) died of tumor metastasis and 3 died of other diseases. CONCLUSION: Unscheduled resection of soft tissue sarcomas often leads to inadequate surgical coverage and the risk of tumor recurrence and metastasis, which may increase tumor-related mortality compared with planned surgery. Clinicians should try to avoid the occurrence of unplanned resections.