四肢或躯干平滑肌肉瘤18例临床分析  

Soft tissue leiomyosarcoma of the trunk and extremities：a retrospective analysis of 18 cases

作　　者：赵振国[1] 张鑫鑫[1] 于胜吉[1] 宋艳[2] 徐立斌[1] 刘婷[1] 叶智斌[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院骨科,北京100021 [2]中国医学科学院北京协和医学院病理科

出　　处：《中国综合临床》2013年第6期618-621,共4页Clinical Medicine of China

摘　　要：目的探讨四肢或躯干软组织平滑肌肉瘤的临床特征、治疗方法和预后情况。方法回顾性分析1999年1月至2012年12月收治的18例四肢或躯干平滑肌肉瘤患者的临床资料。7例外院局部切除术后；2例外院活检术后；8例外院多次术后复发；1例初诊于我院。1例行肿瘤边缘切除；17例行扩大切除。18例患者均获得随访，随访时间16—158个月。结果随访期间9例（50．0％）发生肺转移，其中5例合并局部复发（27．8％）。全组死亡10例，生存8例。10例死亡患者中，7例死于肿瘤进展，3例死于非肿瘤因素。8例生存的患者，2例为带瘤生存。全组5年总生存率为59．2％。结论四肢或躯干软组织平滑肌肉瘤是一种少见的恶性肿瘤，多见于老年人，一般表现为软组织内肿物。复发和转移多见，预后差。手术治疗结合放疗是主要治疗方法。Objective To explore the clinical feature, suitable treatment and prognosis of soft tissue leiomyosarcoma of the trunk and extremities. Methods Clinical data of 18 cases of pathologically confirmed soft tissue leiomyosarcoma of the trunk and extremities from January 1999 to December 2012 were analyzed retrospectively. Primary tumors in 7 cases were marginally excised before admitted to our hospital, 2 had open biopsy before admission to our hospital, and 8 cases had local relapse at admission; Only one patient took our institute as the first visit. Seventeen cases were performed extended excision of tumors and 1 case underwent marginal resection. All the patients were followed up and the follow-up period was from 16 to 158 months. Results During follow-up period, 9 patients developed lung metastasis, and local recurrence occurred in 5 patients. Ten patients died and 8 survived. Of the ten dead cases, seven died of tumor progression and 3 died from non-tumor factors. In the 8 patients survived, 2 survived with tumor. The 5-year overall survival rate was 59.2%. Conclusion Soft tissue leiomyosarcoma of the trunk and extremities are rare malignant tumors, mostly occurred in elder patients and presenting soft tissue mass. Local recurrence and distant metastasis are common and associated with a poor prognosis. Surgical excision combined with adjuvant radiation is the common treatment strategy.

关 键 词：平滑肌肉瘤 软组织肉瘤 转移 预后 

分 类 号：R73[医药卫生—肿瘤]