251例软组织肉瘤临床分析

目的：探讨软组织肉瘤的治疗及影响预后的因素。方法：对251例软组织肉瘤患者的治疗情况及随访结果进行回顾性分析,计算生存率并作单因素及多因素分析。结果：本组患者1、3.5、10年无瘤生存率分别为67.74％、57.16％、52.41％、38.60％。总生存率1年81.01％、3年67.75％、5年60.79％、10年49.23％。Log-rank时序检验结果显示原发与复发、病理分级、病理类型、肿瘤大小、部位、侵犯血管与否、解剖深度、切缘、主要治疗方法、术后辅助治疗、有无血行转移、手术方式对生存率影响差异都有显著性意义。COX回归分析显示患者年龄、肿瘤的病理类型、病理分级、肿瘤大小、有无转移及手术切缘是影响预后的主要因素。结论：软组织肉瘤的治疗提倡广泛切除术及三维切除,合理应用综合治疗及个体化治疗。

Clinical analysis of 251 cases of soft tissue sarcomas

Objective To explore the therapeutic principles and prognostic factors of soft tissue sarcoma. Methods Two hundred and fifty one patients with soft tissue sarcoma (STS) treated at Shanghai Cancer Hospital during 1986 1990 were reviewed retrospectively Results The 1 ,3 ,5 ,10 year tumor free survival rates were 67 74%,57 16%,52 41%,38 60%,respectively. The overall survival rates for 1,3,5 and 10 years were 81 01%,67 75%, 60 79%, and 49 23% respectively Log rank test showed that the patients with different pathological findings, histological grades, mass location and size, anatomical depth, and surgical margin showed different outcomes Whether the sarcomas invaded the vessels or metastasized would influence the survival rates. The patients who underwent different interventions or operations also had different outcomes. The prognosis of STS was associated with age, histological type, histological grade, tumor size, surgical margin and metastasis according to the Cox regression analysis. Conclusion During the treatment of STS, wide resection, especially 3 dimensional resection, comprehensive treatment and individualized treatment should be advocated.