辅助化疗对 FNCLCC 分级 3 软组织肉瘤患者生存的影响：法国肉瘤研究组数据库的多变量分析。
Effect of adjuvant chemotherapy on survival in FNCLCC grade 3 soft tissue sarcomas: a multivariate analysis of the French Sarcoma Group Database.
机构信息
Department of Medical Oncology, Institut Bergonié, Bordeaux.
INSERM CIC-EC7, Université Victor Ségalen, Bordeaux; Clinical Research Unit, Institut Bergonié, Bordeaux.
出版信息
Ann Oncol. 2010 Dec;21(12):2436-2441. doi: 10.1093/annonc/mdq238. Epub 2010 May 3.
BACKGROUND
The predictive value of grade for benefit from adjuvant chemotherapy (AC) in soft tissue sarcoma (STS) patients has never been explored.
PATIENTS AND METHODS
From 1980 to 1999, 1513 adult patients with non-metastatic STS were included prospectively in the French Sarcoma Group database. Grade was assessed according to the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system after central review.
RESULTS
AC was delivered to 13 grade 1 patients (3%), 145 grade 2 patients (35%) and 262 grade 3 patients (62%). Young age, non-well-differentiated liposarcoma histology, deep location, bone and/or neurovascular invasion and grade 2 or 3 were significantly associated with a higher likelihood to receive AC. Median follow-up was 9 years. On multivariate analysis, AC was significantly associated with improved metastasis-free survival (MFS) [5-year MFS: 58% versus 49%, hazard ratio (HR) 0.7 (95% confidence interval (CI) 0.6-0.9), P = 0.01] and overall survival (OS) [5-year OS: 58% versus 45%, HR 0.6 (95% CI 0.5-0.8), P = 0.0002] in grade 3 patients. This was not observed in grade 2 patients [5-year MFS: 76% versus 73%, HR 0.8 (95% CI 0.5-1.2), P = 0.27; 5-year OS: 75% versus 65%, HR 0.8 (95% CI 0.6-1.1), P = 0.15].
CONCLUSION
This large cohort-based analysis with long-term follow-up indicates that patients with FNCLCC grade 3 disease may benefit from AC.
背景
预测软组织肉瘤（STS）患者从辅助化疗（AC）中获益的分级价值从未被探索过。
患者和方法
从 1980 年到 1999 年，1513 名非转移性 STS 成年患者前瞻性地纳入法国肉瘤组数据库。分级根据中央审查后的法国国家癌症中心联合会（FNCLCC）系统进行评估。
结果
13 名患者为 1 级（3%），145 名患者为 2 级（35%），262 名患者为 3 级（62%）接受了 AC。年轻、非高分化脂肪肉瘤组织学、深部位置、骨和/或脉管侵犯以及 2 级或 3 级与更有可能接受 AC 显著相关。中位随访时间为 9 年。多因素分析显示，AC 与无转移生存（MFS）的改善显著相关[5 年 MFS：58%比 49%，风险比（HR）0.7（95%置信区间（CI）0.6-0.9），P=0.01]和总生存（OS）[5 年 OS：58%比 45%，HR 0.6（95%CI 0.5-0.8），P=0.0002]，但在 2 级患者中未观察到[5 年 MFS：76%比 73%，HR 0.8（95%CI 0.5-1.2），P=0.27；5 年 OS：75%比 65%，HR 0.8（95%CI 0.6-1.1），P=0.15]。
结论
这项基于大型队列、具有长期随访的分析表明，FNCLCC 分级 3 级的患者可能从 AC 中获益。
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