Schwab Joseph H, Antonescu Cristina R, Athanasian Edward A, Boland Patrick J, Healey John H, Morris Carol D
Department of Surgery/Section of Orthopedics, Memorial Sloan Kettering Cancer, Weill Cornell Medical School, 1275 York Avenue, New York, NY 10021, USA.
Clin Orthop Relat Res. 2008 Jun;466(6):1318-22. doi: 10.1007/s11999-008-0251-2. Epub 2008 Apr 19.
While low-grade juxtacortical and low-grade intramedullary osteogenic sarcomas are histologically indistinguishable, they have been studied as separate entities. We retrospectively reviewed the clinical, radiographic, histologic features and treatment of 59 patients treated surgically to compare the rate of local recurrence, grade progression, and survival between low-grade intramedullary and low-grade juxtacortical osteogenic sarcoma. Forty-five (76%) patients were treated for low-grade juxtacortical osteogenic sarcoma and 14 (24%) were treated for low-grade intramedullary osteogenic sarcoma. Local recurrence rates of 7% were similar for both groups studied. The rate of distant metastases was also similar for both groups. . The rate of dedifferentiation for the entire group was 29%. Dedifferentiated lesions were treated with adjuvant chemotherapy in 16 of 17 cases. Recurrence preceded dedifferentiation in four cases. Five-year survival was over 90% in both groups. Low-grade intramedullary and low-grade juxtacortical osteogenic sarcoma were clinically indistinguishable with identical rates of local recurrence, distant metastases, dedifferentiation, and survival.
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
虽然低级别皮质旁骨肉瘤和低级别髓内骨肉瘤在组织学上难以区分,但它们一直被作为不同的实体进行研究。我们回顾性分析了59例接受手术治疗患者的临床、影像学、组织学特征及治疗情况,以比较低级别髓内骨肉瘤和低级别皮质旁骨肉瘤之间的局部复发率、分级进展及生存率。45例(76%)患者接受了低级别皮质旁骨肉瘤的治疗,14例(24%)患者接受了低级别髓内骨肉瘤的治疗。两组的局部复发率均为7%,相似。两组的远处转移率也相似。整个组的去分化率为29%。17例去分化病变中有16例接受了辅助化疗。4例患者复发先于去分化。两组的5年生存率均超过90%。低级别髓内骨肉瘤和低级别皮质旁骨肉瘤在临床上难以区分,局部复发率、远处转移率、去分化率及生存率相同。
III级,治疗性研究。有关证据级别的完整描述,请参阅作者指南。