【摘要】 目的评估臀部巨大软组织肉瘤外科治疗的效果和影响最终治疗效果的因素。方法2000至2001年5例臀部巨大软组织肉瘤患者接受外科治疗。年龄18~65岁,平均46·2岁。恶性纤维组织细胞瘤3例,滑膜肉瘤1例,脂肪肉瘤1例。病变的最大径为11~15cm。大部分患者有臀大肌及臀中肌受累。外科治疗为广泛切除(包括臀大肌和臀中肌切除)3例,边缘切除2例。结果术后随访平均35个月(6~52个月),3例无瘤生存,2例出现肺转移并死亡。最年轻的患者为滑膜肉瘤复发,术后3个月出现肺转移并在术后6个月死亡。1例恶性纤维组织细胞瘤患者,术后20个月出现多发肺转移,并在5个月后死亡。其余3例患者无瘤生存。1例脂肪肉瘤患者可以正常行走,2例恶性纤维组织细胞瘤患者虽有跛行,但可以不扶拐长距离行走。结论臀部软组织肉瘤可以通过达到有效外科边界的局部切除进行有效治疗。臀大肌和臀中肌切除术后,行走功能是可以接受的,特别是对老年患者。复发和病变范围广泛的病例治疗效果差。术后可能不需要放疗。肺转移是死亡的主要因素。外科边界和病变的侵袭性是臀部软组织肉瘤预后的主要影响因素。更多还原

【Abstract】 Objective The purpose of this study was to evaluate the effect of surgery and factors which influencing the final outcome of patients. Methods Five patients with huge buttock soft tissue sarcoma were treated surgically (local resection) from 2000 to 2001 in our institute. Patients’ age ranges from 18 to 65 years old and the mean is 46.2 years. The diseases were three MFHs and one synovial sarcoma and one liposarcoma. The maximum diameter of each lesion ranges form 11 to 15 centimeters. Maximum and medium glutei were involved most. Wide resections (including Maximum and medium gluteus resection) were delivered in four patient and marginal resection in one (liposarcoma).Results At a median of 35 months (range, 26 to 52 months) after the operation, three patients were free of disease and two patients with lung metastasis and died of disease. The youngest patient with recurrent synovial sarcoma had pulmonary and second recurrence three months after operation and died six months later. One MFH developed multiple pulmonary metastasis 20 months after operation and died 5 months after metastasis. The rest three patients were free of disease and patient with liposarcoma walks normal and two MFHs are with some limp and could walk long without any support. Conclusions Buttock soft tissue sarcomas could be treated effectively by local resection if the right surgical margin was reached. After resection of the Maximum and medium gluteus, walking function is acceptable. Recurrent and extensive case had bad result after local resection. Post-operative radiation may be not necessary and pulmonary is still the cause of death. Surgical margin and aggressiveness of the disease are the most influencing factors for the outcome of buttock soft tissue sarcoma patients.更多还原