Zusammenfassung
In der Chirurgischen Universitätsklinik Hamburg wurden von 1970–1988 124 Patienten mit Weichteilsarkomen der Extremitäten und des Rumpfs operiert. Liposarkome, maligne fibröse Histiozytome, Fibrosarkome und maligne Schwannome waren die häufigsten histologischen Typen. Niedrig differenzierte Sarkome (G3) überwogen mit einem Anteil von 41%, während 26% als G2 und 33% als G1 imponierten. Bei nur 54% der Patienten wurde eine Tumorresektion mit dreidimensional weitem Sicherheitsabstand durchgeführt. Dabei stellte sich die Qualität der Operation (RO/1/2) als einziger im Rahmen der Therapie beeinflu\barer Prognosefaktor heraus. Daneben wurde in der univariaten Analyse das Tumorgrading, die Tumorgröße, die regionalen Lymphknoten- und Fernmetastasen und der histologische Typ als prognostisch relevant ermittelt. In der multivariaten Analyse behielten die Faktoren Fernmetastasen, Grading, Resektabilität und histologischer Typ statistische Signifikanz. Der Erfolg einer adjuvanten Chemo- und Strahlentherapie war erheblich von der Qualität der vorangegangenen Tumorresektion abhängig. Bei klinisch manifestem Tumor wurde mit einer Chemotherapie bei 28% der Fälle eine Voll- oder Teilremission erreicht, mit einer Strahlentherapie bei 22% der Fälle. Die durchschnittliche Überlebenszeit betrug 102 Monate, die 5- und 10-Jahres-Überlebensrate 48% bzw. 37%.
Summary
Between 1970 and 1988 surgery was performed on 124 patients with soft tissue sarcomas of the extremities and trunk in the University Clinics of Hamburg. Liposarcoma, malignant fibrous histiocytoma, fibrosarcoma and malignant schwannoma were the most common histological types. High-grade sarcomas (G3) predominated, with 41 %, while 26% were graded G2 and 33% G1. Resection with wide margins all round was achieved in only 54% of the patients. The quality of the operation proved to be only therapy-related prognostic factor. In addition, tumour grade, size, regional lymph node and distant metastasis and histological type proved to be relevant to the prognosis. With multivariate analysis, distant metastasis, grade, resectability and histological type retained prognostic significance. The efficacy of adjuvant chemo- and radiotherapy was related to the quality of the preceding tumour resection. In case of gross tumour the rate of either partial or complete response was 28% for chemotherapy and 22% for radiotherapy. The mean survival time was 102 months; the 5- and 10-year survival rates were 48% and 37%, respectively.
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Zornig, C., Weh, HJ., Krüll, A. et al. Soft tissue sarcomas of the extremities and trunk in the adult. Langenbecks Arch Chir 377, 28–33 (1992). https://doi.org/10.1007/BF00186146
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DOI: https://doi.org/10.1007/BF00186146