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原发性非转移性骨肉瘤患者对新辅助化疗反应不良的生存预后因素。

Prognostic factors in the survival of patients diagnosed with primary non-metastatic osteosarcoma with a poor response to neoadjuvant chemotherapy.

机构信息

Faculty of Medicine, University of Campina Grande - Campina Grande/PB, Brazil.

出版信息

Clinics (Sao Paulo). 2009;64(12):1177-86. doi: 10.1590/S1807-59322009001200007.

DOI:10.1590/S1807-59322009001200007
PMID:20037705
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2797586/
Abstract

INTRODUCTION

Identification of variables that determine the prognosis for osteosarcoma may enable stratification of patients into subgroups with better or worse risk of local recurrence, metastases and death due to the disease. Discovery of such prognostic factors would permit selection of a subgroup of at-risk patients, with the aim of improving the therapeutic effectiveness.

OBJECTIVE

To identify prognostic factors related to local recurrence-free survival, metastasis-free survival and overall survival among patients with highly malignant primary osteosarcoma that was non-metastatic on diagnosis and had poor response to neoadjuvant chemotherapy.

SAMPLE AND METHODS

Out of 45 patients admitted to a referral center in Brazil between 2000 and 2004, 24 were selected for this study.

RESULTS

The adverse factors that influenced the risk of local recurrence and the overall survival in univariate analysis were histological subtype other than osteoblastic (p = 0.017) and tumor size greater than 15 cm (p = 0.048). In relation to metastasis-free survival, the non-osteoblastic subtype had a worse prognosis (p = 0.007). The association of histological subtype maintained its significance in multivariate analysis for all studied survival categories.

CONCLUSIONS

Tumor size greater than 15 cm is an adverse factor for local recurrence-free survival and overall survival but did not influence metastasis-free survival. The osteosarcoma histological type is a significant independent predictor for local recurrence-free survival, metastasis-free survival and overall survival.

摘要

简介

确定影响骨肉瘤预后的变量，可能使患者分为局部复发、转移和疾病相关死亡风险较低或较高的亚组。发现这些预后因素将允许选择高危患者亚组，以提高治疗效果。

目的

确定与无局部复发生存、无转移生存和总生存相关的预后因素，这些患者的初诊骨肉瘤为高度恶性、无转移且对新辅助化疗反应不佳。

样本和方法

2000 年至 2004 年间，巴西一家转诊中心收治的 45 名患者中，有 24 名被纳入本研究。

结果

单因素分析中，影响局部复发风险和总生存的不良因素包括组织学亚型非成骨型（p=0.017）和肿瘤大小大于 15cm（p=0.048）。在无转移生存方面，非成骨型亚型的预后较差（p=0.007）。组织学亚型的相关性在多因素分析中对于所有研究的生存类别均具有统计学意义。

结论

肿瘤大小大于 15cm 是局部无复发生存和总生存的不良因素，但不影响无转移生存。骨肉瘤的组织学类型是局部无复发生存、无转移生存和总生存的显著独立预测因素。

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