189 KB18 KB199220252000Temple, Walley J.številka:3letnik:34str. 269-273COBISSID:11944921ISSN:1318-2099URN:URN:NBN:SI:doc-NMBO7A0JenCroatian Medical Association - Croatian Society of RadiologySlovenian Medical Society - Section of RadiologyRadiology and oncology (Ljubljana)Extremitieskirurško zdravljenjeNeoplasm stagingokončinerak (medicina)SarcomasarkomSoft tissue neoplasmsSurgerySurvival analysisLimb salvage in soft tissue sarcomas| Terapija z ohranitvijo organov pri zdravljenju sarkomov mehkih tkiv|In 2000, most patients with soft tissue sarcomas of the axial or appendicular skeleton can expect 'to walk away' from the surgery. This compares to just 20 years ago when a relatively high percentage of patients were treated with amputation. Now the treatment has changed to one of wide local excision with a1 cm to 2 cm margin on normal tissues and an adventitial margin on critical structures such as nerves or vessels, followed or preceded by radiotherapy. With the use of adjuvant treatments in combination with reconstructive surgery, over 90% of patients with sarcomas of the soft tissues or bone may berendered disease free locally. The only restriction to this approach is whentumor involves the major nerve to a limb or when microscopic, clear margins cannot be obtained at the time of surgery as both of these are best treated with an imputationSedaj, v letu 2000 lahko večina bolnikov s sarkomi mehkih tkiv pričakuje, da bo hodila po operaciji, kar predstavlja velik napredek v primerjavi z zdravljenjem pred 20 leti, ko je bila amputacija okončin standardni način zdravljenja. Danes se zdravi s široko lokalno ekscizijo z varnostnim robom 1-2cm v zdrava tkiva, v kombinaciji z radioterapijo pred ali po operaciji. Lokalno lahko na tak način z rekonstrukcijsko kirurgijo in adjuvantnim zdravljenjem dosežemo 90% kontrolo rasti tumorja. Edina omejitev za tak poseg je, ko je bolezen napredovala in objela živce okončine, ali če ne moremo pri operaciji doseči čistih robov, takrat je še vedno potrebna amputacija okončineTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaOnkološki inštitut Ljubljana