四肢软组织平滑肌肉瘤的治疗与预后探讨  

Analysis of treatment and prognosis of extremities soft tissue leiomyosarcoma

作　　者：许晶晶[1] 韦永中[1] 李菊明[1] 

机构地区：[1]南京医科大学第一附属医院骨科,江苏南京210029

出　　处：《中国肿瘤外科杂志》2017年第1期25-28,共4页Chinese Journal of Surgical Oncology

摘　　要：目的探讨四肢软组织平滑肌肉瘤(leiomyosarcoma,LMS)的临床特征、治疗方法及预后。方法回顾分析南京医科大学第一附属医院2008年1月至2015年4月收治的15例四肢软组织平滑肌肉瘤患者的临床资料,并复习相关文献。结果病变位于上肢1例,下肢14例。影像学表现缺乏特异性,CT和MRI有助于确定病变范围和手术方案。AJCC分期ⅠA期2例,ⅠB期1例,ⅡA期3例,ⅡB期6例,Ⅲ期1例,Ⅳ期2例。2例行髋关节离断术,其余13例行保肢术,其中6例辅以化疗,2例辅以放疗。15例患者均获随访12.0~215.0个月,中值时间42个月,其中9例发生复发和(或)转移;5例死于肺转移,10例存活患者中3例为带瘤生存。结论手术为四肢软组织平滑肌肉瘤的主要治疗手段,规范放化疗有助于提高患者生存率。发生远处转移的患者预后欠佳。Objective To explore the clinical features, treatment and prognosis of extremities soft tis- sue leiomyosarcoma（LMS）. Methods 15 cases of LMS were analyzed retrospectively and the relevant literature was reviewed. Results One of the 15 patients had lesions involving the upper limbs, the others involving the lower limb. There were no specific imaging findings. CT and MRI is helpful to determine the invasion scope of tumor. According to AJCC stage, there were 2 tumor cases in I A stage, 1 case in ] B stage, 3 cases in ]] A stage, 6 cases in l~ B stage, 1 case in m stage, 2 cases in IV stage. Two patients underwent hip disarticula- tion, whereas among the remaining 13 patients a limb-sparing surgeries were performed. Six patients were man- aged with chemotherapy, and two patients were managed with radiotherapy. Follow-up times are from 12. 0 to 215.0 months, while the median follow-up time was 42 months. Nine patients developed recurrence and/or me- tastasis, five died of lung metastases, and three survive with tumor. Conclusions Surgical treatment is the pri- mary method for extremities LMS, standard radiotherapy and chemotherapy helps to improve the survival rate. Distant metastasis is associated with a poor prognosis.

关 键 词：四肢软组织平滑肌肉瘤 手术治疗 预后 

分 类 号：R738.6[医药卫生—肿瘤]