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目的探讨软组织肉瘤患者非计划手术后的再手术切除及其治疗效果。方法回顾性分析44例已行非计划手术的软组织肉瘤患者行二次扩大切除术的复发、转移及生存情况等治疗效果。结果二次手术前无复发组共17例,2例在术后出现局部复发(11.8%),1例淋巴结转移并带瘤生存(5.9%),1例肺转移死亡。二次手术前已复发组共27例,13例在术后出现局部复发(48.1%),8例肺、肝或多发转移(29.6%),7例肺、肝或多发转移而死亡。两组的二次复发情况有显著性差异(P=0.021);转移情况无显著性差异(P=0.121)。患者在二次手术前是否复发及二次手术后是否复发对所有患者的总体生存情况影响无显著差异(P>0.05);两组患者总的5年无病生存率分别为86.3%±9.2%及40.3%±10.1%,有显著差异(P=0.003)。结论软组织肉瘤的局部复发对肿瘤的转移率及患者的总体生存率无明显影响,但会明显降低患者的无病生存率。软组织肉瘤一旦诊断明确应及时行二次扩大切除术治疗。
Objective To investigate the surgical resection and its therapeutic effect after unplanned surgery in patients with soft tissue sarcoma. Methods Retrospective analysis of 44 cases of patients with soft tissue sarcoma who had undergone unplanned surgery underwent resection, metastasis and survival after secondary resection. Results There were 17 cases without recurrence before operation, 2 cases with local recurrence after operation (11.8%), 1 case with lymph node metastasis and tumor survival (5.9%), and 1 case died of pulmonary metastasis. A total of 27 patients had relapsed before surgery. Thirteen patients had local recurrence after surgery (48.1%), 8 patients died of lung, liver or multiple metastasis (7), and 7 patients had lung, liver or multiple metastases. There was a significant difference in secondary relapse between the two groups (P = 0.021); there was no significant difference in metastasis (P = 0.121). There was no significant difference in the overall survival of all patients (P> 0.05). The overall 5-year disease-free survival rates of the two groups were 86.3% ± 9.2% And 40.3% ± 10.1%, respectively (P = 0.003). Conclusion Local recurrence of soft tissue sarcoma has no significant effect on tumor metastasis rate and overall survival rate of patients, but will significantly reduce the patients’ disease-free survival rate. Once the diagnosis of soft tissue sarcoma should be promptly performed twice extended excision.