深部软组织上皮样血管肉瘤的临床研究  

The clinical study of epithelioid angiosarcoma in deep soft tissue

作　　者：范宏斌[1] 郭征[1] 吴智刚[1] 栗向东[1] 李靖[1] 王臻[1] 

机构地区：[1]第四军医大学西京医院骨肿瘤科,西安710032

出　　处：《中华外科杂志》2011年第11期982-985,共4页Chinese Journal of Surgery

摘　　要：目的 分析位于深部软组织内上皮样血管肉瘤（EA）的病理特征、手术切除后远期生存率、局部复发率、转移率及术后功能,探讨影响其生存率的因素.方法 2001年5月至2011年5月,7例深部软组织EA患者在我科接受治疗.所有患者经X线、CT、磁共振成像等影像学检查,并经病理学诊断证实.按照Enneking外科分期：ⅡA期3例、ⅡB期3例、Ⅲ期1例.7例患者中4例行截肢术,3例行肿瘤病灶扩大切除保肢术.术后均辅助以放、化疗.7例均获得随访,随访时间3～20个月,平均随访时间11.7个月.结果 行肿瘤扩大切除的3例患者中有1例在术后3个月发生局部复发,需再次行截肢手术.5例患者在术后4～20个月内发生远处转移,3例为肺转移,2例为全身多处广泛转移.半年生存率为67％,1年生存率22％,2年生存率0.保肢的3例患者依据Enneking术后功能评价标准,优2例,差1例.手术外科边界、肿瘤发生部位、肿瘤分期是影响深部软组织EA患者生存率的重要因素.结论 深部软组织EA的预后较差,根据患者特点采取更为广泛的切除,制定个体化综合治疗方案可能提高生存率,降低局部复发率和远处转移率.Objective To analyze the histopathology of,surgery for,and prognosis （ survival rate,local recurrence rate,metastases rate,function） of epithelioid angiosarcoma （ EA ）.Methods Seven patients diagnosed as EA were received treatment in our department from May 2001 to May 2011.According Enneking staging,3 patients were classified as Ⅱ A,3 for Ⅱ B,and 1 for Ⅲ.Wide excision was performed in 3 patients and amputation in 4 patients.Seven patients were followed up from 3 to 20 months.Results One patient had local recurrence 3 months after wide excision.Five patients had metastases at 4 to 20 months postoperatively.The cumulative survival rate at 0.5,1 and 2 years postoperatively were 67%,22% and 0.The function of 3 patients after limb salvage operation was good in 2 cases and poor in 1 case.The tumor site,surgical staging,and safe margin were crucial factors affecting survival rate.Conclusions The prognosis of EA in deep soft tissue was poor.Customized,multimodality treatment and safe margin in operation may increase the survival rate as well as decrease recurrence and metastasis.

关 键 词：血管肉瘤 预后 因素分析 统计学 

分 类 号：R738.6[医药卫生—肿瘤]