Abstract：
Foot and ankle soft tissue sarcomas (STSs) are rare neoplasms associated with a high risk of local recurrence and metastasis. Although amputation is often performed, its impact on prognosis remains unknown. The aims of our systematic review were identifying risk factors for (1) disease-specific death, (2) local recurrence, (3) metastasis, and assessing (4) whether the type of surgery (amputation or limb-salvage) affected disease-specific survival.
This systematic review was conducted following PRISMA guidelines. The PubMed, Embase, and Scopus databases were searched. Our study was registered in PROSPERO (ID: 415624). Quality appraisal was done using STROBE guidelines.
A total of 7 studies and 123 patients were included. Metastasis was the only risk factor for disease-specific death (OR = 107.85, P< .001). Previous unplanned excision (OR = 22.29, P = .009) and positive margins (OR = 64.48, P = .011) were associated with higher risk of local recurrence. Patients with high-grade tumors (OR = 13.22, P = .023) and tumors ≥6 cm (OR = 7.40, P = .022) were more likely to develop metastases. After adjusting for confounders (age, sex, and presence of metastasis), amputation was not associated with poorer disease-specific survival.
Metastasis was the single most important risk factor for death with foot and ankle soft tissue sarcoma. Positive margins and history of previous unplanned excision are risk factors for local recurrence. The most important risk factors for metastasis are tumor grade and size ≥6 cm. Amputation was not associated with poorer disease-specific survival.
This systematic review was conducted following PRISMA guidelines. The PubMed, Embase, and Scopus databases were searched. Our study was registered in PROSPERO (ID: 415624). Quality appraisal was done using STROBE guidelines.
A total of 7 studies and 123 patients were included. Metastasis was the only risk factor for disease-specific death (OR = 107.85, P< .001). Previous unplanned excision (OR = 22.29, P = .009) and positive margins (OR = 64.48, P = .011) were associated with higher risk of local recurrence. Patients with high-grade tumors (OR = 13.22, P = .023) and tumors ≥6 cm (OR = 7.40, P = .022) were more likely to develop metastases. After adjusting for confounders (age, sex, and presence of metastasis), amputation was not associated with poorer disease-specific survival.
Metastasis was the single most important risk factor for death with foot and ankle soft tissue sarcoma. Positive margins and history of previous unplanned excision are risk factors for local recurrence. The most important risk factors for metastasis are tumor grade and size ≥6 cm. Amputation was not associated with poorer disease-specific survival.
摘要：
■足踝部软组织肉瘤（STSs）是罕见的肿瘤，与局部复发和转移的高风险相关。虽然经常进行截肢，其对预后的影响尚不清楚.我们系统评价的目的是确定（1）疾病特异性死亡的危险因素，（2）局部复发，（3）转移，并评估（4）手术类型（截肢或肢体抢救）是否影响疾病特异性生存率。
■这项系统评价是按照PRISMA指南进行的。PubMed,Embase,搜索了Scopus数据库。我们的研究在PROSPERO注册（ID：415624）。使用STROBE指南进行质量评估。
■共纳入7项研究和123例患者。转移是疾病特异性死亡的唯一危险因素(OR=107.85,P<.001)。先前的非计划切除（OR=22.29，P=.009）和阳性切缘（OR=64.48，P=.011）与较高的局部复发风险相关。高级别肿瘤(OR=13.22,P=.023)和肿瘤≥6cm(OR=7.40,P=.022)患者更容易发生转移。在调整了混杂因素(年龄，性别,和转移的存在)，截肢与较差的疾病特异性生存率无关.
■转移是导致足踝部软组织肉瘤死亡的最重要的危险因素。切缘阳性和既往非计划切除史是局部复发的危险因素。转移最重要的危险因素是肿瘤分级和大小≥6cm。截肢与较差的疾病特异性生存率无关。
■这项系统评价是按照PRISMA指南进行的。PubMed,Embase,搜索了Scopus数据库。我们的研究在PROSPERO注册（ID：415624）。使用STROBE指南进行质量评估。
■共纳入7项研究和123例患者。转移是疾病特异性死亡的唯一危险因素(OR=107.85,P<.001)。先前的非计划切除（OR=22.29，P=.009）和阳性切缘（OR=64.48，P=.011）与较高的局部复发风险相关。高级别肿瘤(OR=13.22,P=.023)和肿瘤≥6cm(OR=7.40,P=.022)患者更容易发生转移。在调整了混杂因素(年龄，性别,和转移的存在)，截肢与较差的疾病特异性生存率无关.
■转移是导致足踝部软组织肉瘤死亡的最重要的危险因素。切缘阳性和既往非计划切除史是局部复发的危险因素。转移最重要的危险因素是肿瘤分级和大小≥6cm。截肢与较差的疾病特异性生存率无关。
