Clinical Analysis on 11 Cases of Epithelioid Sarcoma of Taipei Veterans General Hospital

上皮樣肉瘤－台北榮民總醫院11例治療經驗

廖文傑(Wen-Chieh Liao) ； 林素娥(Su-Er Lin) ； 林進德(Jin-Teh Lin) ； 馬旭(Hsu Ma)

《臺灣整形外科醫學會雜誌》 19卷4期 (2010/12) Pp. 310-318

https://doi.org/10.7096/TJTSPS.201012.0310

摘要

背景： 上皮樣肉瘤是臨床上罕見的腫瘤，具有高度局部再發及遠處轉移特性。 目的： 我們提出臨床上治療上皮樣肉瘤經驗並加以分析討論。 材料及方法： 從1980到2009，共有11位上皮樣肉瘤病患在台北榮民總醫院接受治療，我們利用回溯分析其肉瘤特性及其臨床上治療。病患平均年齡49歲(24-67 years)，分別接受手術廣泛切除上皮樣肉瘤病灶同時針對淋巴結廓清治療與放射線及化學藥物輔助療法。 結果： 11位病患中，6位出現局部再發，5位出現淋巴結轉移，9位病患初次確定診斷3年後死亡。病患二年存活率46.4%；五年存活率18.2%。 結論： 上皮樣肉瘤預後較差，具有高度淋巴轉移特性，適當手術廣泛切除合併放射線及化學藥物輔助療法是針對上皮樣肉瘤的治療選擇。

並列摘要

Background:
Epithelioid sarcoma (ES) is a rare malignant soft tissue sarcomas with a high risk of recurrence and distant metastases.
Aim and Objectives:
We reviewed our experience in treating patients with this disease. The clinical features, diagnosis, treatment and prognostic factors of patients with epithelioid sarcoma were studied.
Materials and Methods:
The clinical data of 11 patients with epithelioid sarcoma, admitted to our hospital from 1980 to 2009, were analyzed. The rates of survival is established using the Kaplan-Meier method. There were 9 males and 2 females. The patients' ages at the initial onset were 24-67 years, averaged 49 years. Eight patients received wide excision and 4 of them also received local lymph node dissection, and three patients received local excision at our hospital. All the patients underwent some radiotherapy and chemotherapy after operation.
Results:
The diagnosis of ES was confirmed by a review of the pathology at our hospital. Long-term follow-up of the 11 patients, 6 (54.5%) had local recurrence and 5 (45.4%) had local lymph node metastasis, 9 (81.8%) died within 3 years after initial operation. The overall 2-, 5--year survival rates were 46.4%, 18.2%, respectively.
Conclusions:
The prognosis of epithelioid sarcoma is poor because of a high propensity for local recurrence, node metastases, and distant metastases. Wide excision combined with postoperative chemotherapy and radiotherapy is the therapy of choice for treating epithelioid sarcoma.

並列關鍵字

epithelioid sarcoma ； chemotherapy ； radiotherapy