[Extremity soft tissue sarcoma: does surgical margin impact survival?]

IF 0.5 4区医学 Q4 SURGERY

Cirugia Y Cirujanos Pub Date : 2023-12-07 DOI:10.24875/CIRU.22000202

Rafael Medrano-Guzmán, Moises Brener-Chaoul, Luis E García-Ríos, Marisol Luna-Castillo

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引用次数: 0

Abstract

Objective: To define the impact of surgical margins on local recurrence (LR), distant recurrence (DR) and overall survival (OS) in patients with soft tissue sarcomas of the extremities (eSTS).

Method: Patients treated for a primary eSTS from 2006 to 2010 were analyzed. Rates of local recurrence, distant recurrence, and overall survival were estimated using the Kaplan-Meier method. The association of possible prognostic factors such as local recurrence, metastasis, and survival was performed using the Cox proportional hazards model.

Results: 128 patients were analyzed. The surgical margins were positive (R1 resection) in 22.7% and negative in 77.3%. The LR was 27%, the DR was 13% (70% of the population was free of disease at 5 years) and OS at 5 years was 84%. The prognostic factors for OS at 5 years were clinical stage, type and histological grade. The surgical margin had no impact on OS.

Conclusions: Although an adequate oncological resection cannot be underestimated, this should be considered in the decision of the optimal treatment of eSTS when amputation or significant functional impairment of the limb is required to obtain negative surgical margins.

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[肢体软组织肉瘤：手术切缘对存活率有影响吗？］

目的：确定手术切缘对四肢软组织肉瘤（eSTS）患者局部复发（LR）、远处复发（DR）和总生存率（OS）的影响：明确手术切缘对四肢软组织肉瘤（eSTS）患者局部复发（LR）、远处复发（DR）和总生存率（OS）的影响：方法：对2006年至2010年接受原发性肢端软组织肉瘤治疗的患者进行分析。采用卡普兰-梅耶法估算了局部复发率、远处复发率和总生存率。采用考克斯比例危险模型对局部复发、转移等可能的预后因素与生存率之间的关系进行分析：分析了 128 例患者。22.7%的患者手术切缘为阳性（R1切除），77.3%为阴性。LR为27%，DR为13%（70%的患者在5年后无疾病），5年后的OS为84%。5年生存率的预后因素包括临床分期、类型和组织学分级。手术切缘对OS没有影响：尽管不能低估充分的肿瘤切除，但在决定 eSTS 的最佳治疗方法时，如果需要截肢或肢体功能严重受损才能获得阴性手术切缘，则应考虑到这一点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cirugia Y Cirujanos 医学-外科

CiteScore

0.90

自引率

20.00%

发文量

207

审稿时长

6-12 weeks

期刊介绍： Cirugía y Cirujanoses exponente del desarrollo académico, científico, médico, quirúrgico y tecnológico en materia de salud en México y en el ámbito internacional. Es una revista bimestral, open access, revisada por pares, que publica en español y en inglés (traducido sin coste para los autores) artículos científicos originales, casos clínicos, artículos de revisión de interés general y cartas al editor. Los artículos se seleccionan y publican siguiendo un riguroso análisis, de acuerdo con los estándares internacionalmente aceptados. Sus espacios están abiertos a los académicos, así como a todo miembro de la comunidad médica que manifieste interés por utilizar este foro para publicar sus trabajos.