Background/Objectives: Soft tissue sarcomas (STS) of the hand are rare, representing only 2% of all STS. The small size and benign appearance of these tumors often lead to unplanned excisions and diagnostic delay. This systematic review sought to characterize the clinical presentation, histology, treatment modalities, and oncological outcomes of hand STS. Methods: A systematic review of PubMed and Embase was conducted following PRISMA guidelines. The protocol was registered on PROSPERO. We included studies with ≥10 patients with STS that provided data on treatment options and oncologic outcomes. Data was extracted regarding demographics, tumor features, treatment modalities, and survival metrics. Results: Eighteen studies comprising 570 patients were included. Most tumors were <5 cm, and 56.8% were deep (subfascial). Epithelioid and synovial sarcomas were the most common histologies, accounting for 27% and 17% of cases, respectively. UEs were seen in 57% of cases, and 26% of patients required amputation. Positive surgical margins were reported in 16% of patients. Radiation therapy and chemotherapy were used in 40% and 17% of patients, respectively. Twelve and 15% of patients developed regional lymph node and distant metastases, respectively. Local recurrence occurred in 20% of cases. Five- and ten-year overall survival were 80% and 77%, respectively. Disease-free survival at those time points were 77% and 74%, respectively. Conclusions: Hand STSs are challenging due to their rarity, small size, and high rates of UEs. Despite favorable survival rates, local recurrence and metastases remain a concern. Early referral to specialized centers and individualized treatment strategies are essential for improving outcomes.
背景/目的：手部软组织肉瘤（STS）较为罕见，仅占所有STS的2%。这类肿瘤体积小且外观良性，常导致计划外切除和诊断延误。本系统综述旨在描述手部STS的临床表现、组织学特征、治疗方式及肿瘤学预后。方法：遵循PRISMA指南对PubMed和Embase数据库进行系统综述，研究方案已在PROSPERO平台注册。纳入标准为包含≥10例STS患者且提供治疗方案及肿瘤预后数据的研究。提取数据包括人口统计学特征、肿瘤特征、治疗方式和生存指标。结果：共纳入18项研究，涉及570例患者。多数肿瘤直径<5厘米，56.8%为深部（筋膜下）肿瘤。上皮样肉瘤和滑膜肉瘤是最常见的组织学类型，分别占病例总数的27%和17%。57%的病例发生计划外切除，26%的患者需行截肢手术。16%的患者报告手术切缘阳性。放疗和化疗使用率分别为40%和17%。区域淋巴结转移和远处转移发生率分别为12%和15%。局部复发率为20%。五年和十年总生存率分别为80%和77%，无病生存率分别为77%和74%。结论：手部STS因罕见性、体积小及高计划外切除率而具有诊疗挑战性。尽管生存率较为理想，但局部复发和转移仍是重要问题。早期转诊至专科中心并制定个体化治疗策略对改善预后至关重要。
肿瘤(癌症)患者之家