Springfield D S, Schakel M E, Spanier S S
W. Thaxton Springfield Study Center, Department of Orthopaedics, University of Florida, Gainesville.
Clin Orthop Relat Res. 1991 Feb(263):233-7.
The percentage of necrosis in a primary osteosarcoma after the patient has received preoperative chemotherapy is prognostic and is usually used to select subsequent chemotherapy. However, the percentage of necrosis that occurs spontaneously, without preoperative chemotherapy, has not been adequately studied. The examination of histologic macrosections of 76 osteosarcomas from patients who had not received preoperative treatment and of 20 patients who had received preoperative chemotherapy revealed a significant difference in the percentage of necrosis. There was minimal spontaneous necrosis, but necrosis after preoperative chemotherapy was usually extensive. The larger the tumor, the greater the percentage of spontaneous necrosis; however, size did not correlate with the percentage of necrosis with preoperative chemotherapy. Survival among those patients who did not receive preoperative treatment correlated with the size and percentage of necrosis. Necrosis in an osteosarcoma in a patient who has received preoperative chemotherapy can be considered the result of chemotherapy and not a spontaneous event.
原发性骨肉瘤患者接受术前化疗后的坏死百分比具有预后意义，通常用于选择后续化疗方案。然而，未经术前化疗而自发出现的坏死百分比尚未得到充分研究。对76例未接受术前治疗的骨肉瘤患者以及20例接受术前化疗的患者的组织学大体切片进行检查后发现，坏死百分比存在显著差异。自发坏死极少，但术前化疗后的坏死通常较为广泛。肿瘤越大，自发坏死的百分比越高；然而，肿瘤大小与术前化疗后的坏死百分比并无关联。未接受术前治疗的患者的生存率与肿瘤大小及坏死百分比相关。接受术前化疗的患者骨肉瘤中的坏死可被视为化疗的结果，而非自发事件。
