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Title: [Analysis of clinicopathological characteristics and prognostic factors of foot and ankle soft tissue and bone tumors].
Author: Zhang XX, Xu LB, Xu SF, Zhao ZG, Liu T, Zhang SG, Yu SJ.
Journal: Zhonghua Zhong Liu Za Zhi; 2018 Sep 23; 40(9):685-689. PubMed ID: 30293395.
Abstract:
Objective: To evaluate the clinicopathological characteristics of foot and ankle soft tissue and bone tumor, and to analyze the prognosis and the related factors of malignant tumors in this site. Methods: 74 patients with soft tissue and bone tumors of foot and ankle from January 2006 to February 2017 were retrospectively analyzed. The clinicopathological characteristics, the treatment and survival status of malignant tumors were followed up, and the clinical and therapeutic factors related to prognosis were analyzed. Results: Of the 74 patients, 34 were males and 40 were females. The male to female ratio was 1∶1.18; the age ranged from 12 to 64 years and the median age was 42 years. Tumors located in forefoot of 22 cases, 22 in midfoot, 10 in hind foot, 14 in ankle joint and 6 in multiple sites. 14 cases were bone tumors, including 7 benign and 7 malignant, and 60 cases were soft tissue tumors, including 14 benign and 46 malignant. The most common malignant soft tissue tumors were synovial sarcomas (13 cases), and the most common benign soft tissue tumors were hemangiomas (4 cases). 44 cases of malignant tumors underwent surgery were followed up, of which were 7 bone and 37 soft tissue malignant tumors. Limb salvage surgeries were performed in 33 cases and amputation in 11 cases. The median follow-up time was 69.8 months, and the median survival time was 40.7 months. The 1-year, 3-year and 5-year survival rate of soft tissue malignant tumors was 88.0%, 73.0%, and 63.0%, respectively. The 1-year, 3-year and 5-year survival rate of bone malignant tumors was 86.0%, 57.0% and 57.0%, respectively. Univariate analysis showed that the prognostic factors affecting 5-year survival rate were tumor size and adjuvant therapy (P<0.05). Patient's gender, age, tumor location, histological type and surgical procedure had no effect on overall survival(P>0.05). Multivariate analysis showed that tumor size was an independent prognostic factor (RR=7.262, P=0.005). Conclusions: Forefoot and midfoot are more common in foot and ankle soft tissue and bone tumors. Synovial sarcoma is the most common diagnosis in malignant soft tissue tumors, and hemangioma is the most common diagnosis in benign soft tissue tumors. The prognostic factor of malignant soft tissue and bone tumors in foot and ankle is tumor size. Patients with the tumor size of 5 cm or more have a worse prognosis. 目的： 探讨足踝部软组织肿瘤和骨肿瘤患者的临床病理特征、预后及其影响因素。 方法： 回顾性分析中国医学科学院肿瘤医院2006年1月至2017年2月收治的74例足踝部软组织肿瘤和骨肿瘤患者的临床和随访资料，分析其临床病理特征和影响预后的因素。 结果： 74例患者中，男34例，女40例，男女比例为1∶1.18；年龄为12～64岁，中位年龄为42岁。肿瘤发生于前足22例，中足22例，后足10例，踝关节14例，多部位发病6例。骨肿瘤14例，其中良性和恶性骨肿瘤均为7例；软组织肿瘤60例，其中良性和恶性软组织肿瘤分别为14例和46例。最常见的恶性软组织肿瘤为滑膜肉瘤(13例)，最常见的良性软组织肿瘤为血管瘤(4例)。接受手术并获得随访的足踝部恶性肿瘤共44例，其中骨恶性肿瘤7例，软组织恶性肿瘤37例；接受保肢手术33例，截肢手术11例。44例患者的中位随访时间为69.8个月，中位生存时间为40.7个月。其中软组织恶性肿瘤患者的1、3和5年生存率分别为88.0%、73.0%和63.0%，骨恶性肿瘤患者的1、3和5年生存率分别为86.0%、57.0%和57.0%。单因素分析结果显示，影响44例足踝部恶性肿瘤患者5年生存率的因素为肿瘤大小和辅助治疗(均P<0.05)，而患者的性别、年龄、发病部位、组织类型和手术方式等对患者的预后无影响(均P>0.05)。多因素分析结果显示，肿瘤大小为影响44例足踝部恶性肿瘤患者预后的独立因素(RR＝7.262，P＝0.005)。 结论： 足踝部软组织肿瘤和骨肿瘤多发生于前足和中足，恶性软组织肿瘤以滑膜肉瘤最为常见，良性软组织肿瘤以血管瘤最为常见。影响足踝部恶性肿瘤患者预后的因素为肿瘤大小，肿瘤>5 cm的足踝部恶性肿瘤患者的预后更差。.

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