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目的:探讨软组织骨肉瘤的临床表现、治疗方法、疗效及预后。方法:回顾性分析浙江大学医学院附属第二医院骨科2002年1月-2014年12月收治的10例软组织骨肉瘤患者的临床病理资料和随访资料。结果:10例软组织骨肉瘤患者中,男性6例,女性4例;7例的肿瘤位于肢体,1例位于腹股沟,1例位于髂部,1例位于髋部;肿瘤位于深筋膜深层7例,位于深筋膜浅层3例;4例的肿瘤最大直径>10 cm,4例的肿瘤直径为5~10cm,2例的肿瘤直径<5 cm;9例为高级别骨肉瘤,1例为中至低级别骨肉瘤。所有患者均接受手术切除,4例接受术后化疗,无患者接受术后放疗。5例出现局部复发,其中4例伴远处转移,无单纯转移患者。3例死于肺转移。结论:软组织骨肉瘤的发病率低,恶性程度高,容易发生局部复发及远处转移,死亡率高。广泛手术切除是软组织骨肉瘤主要的治疗手段,其预后与手术切除范围及肿瘤大小密切相关;化疗的作用尚不明确;一般不给予放疗。
Objective: To investigate the clinical manifestations, treatment, efficacy and prognosis of soft tissue osteosarcoma. Methods: The clinical and pathological data and follow-up data of 10 patients with osteosarcoma of soft tissue admitted from January 2002 to December 2014 in the Second Affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed. Results: Among the 10 patients with osteosarcoma of soft tissue, 6 were male and 4 were female. Seven of the tumors were located in the limbs, one in the groin, one in the iliac crest and one in the hip. The tumor was located deep in the deep fascia , Located in the superficial deep fascia in 3 cases; 4 cases of tumor diameter> 10 cm, 4 cases of tumor diameter of 5 ~ 10cm, 2 cases of tumor diameter <5 cm; 9 cases of high grade osteosarcoma, 1 case Medium to low-grade osteosarcoma. All patients underwent surgical resection, 4 received postoperative chemotherapy, and no patient received postoperative radiotherapy. 5 cases of local recurrence, of which 4 cases with distant metastasis, no simple transfer of patients. 3 died of lung metastases. Conclusion: The incidence of soft tissue osteosarcoma is low, the degree of malignancy is high, prone to local recurrence and distant metastasis, the mortality rate is high. A wide range of surgical resection of soft tissue osteosarcoma is the main treatment, the prognosis and surgical resection range and tumor size are closely related; the role of chemotherapy is not clear; generally do not give radiotherapy.