组织学类型预测腹膜后软组织肉瘤患者的生存。

Histologic type predicts survival in patients with retroperitoneal soft tissue sarcoma.

机构信息

Department of Surgery, Division of Surgical Oncology, University of California, Davis Medical Center, Sacramento, Califronia, USA.

出版信息

J Surg Res. 2012 Jan;172(1):123-30. doi: 10.1016/j.jss.2010.07.056. Epub 2010 Sep 16.

DOI:10.1016/j.jss.2010.07.056

PMID:20869082

Abstract

BACKGROUND

Histologic grade, completeness of resection, and presence of metastases are traditionally regarded as the primary factors in predicting survival for retroperitoneal soft tissue sarcoma (RPSTS). We sought to examine the importance of histologic type as a prognostic factor among patients with RPSTS.

METHODS

We identified 2337 cases of RPSTS in the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2004. After excluding 273 cases of age <18, identification by autopsy only, or absence of histologic confirmation, we arrived at a final study cohort of 2064 patients. Overall survival (OS) and disease-specific survival (DSS) were estimated using the Kaplan-Meier method. Multivariate analysis was performed using a Cox proportional hazards model, adjusting for age, gender, race, histologic type, histologic grade, tumor size, extent of resection, and SEER summary stage.

RESULTS

Among 33 histologic types, leiomyosarcoma (28.7%), well-differentiated/dedifferentiated liposarcoma (20.3%), liposarcoma not otherwise specified (NOS) (11.9%), malignant fibrous histiocytoma (MFH-11.0%), and sarcoma NOS (10.7%) were the most prevalent. Grade distribution was low, 24.2%; intermediate, 16%; high 34.3%, and unknown, 25.5%. Surgery was performed in 85.8%, and radiotherapy was administered to 22.8%. With a median follow-up of 38 mo, median OS was 78, 35, 25, 18, and 10 mo for liposarcoma, leiomyosarcoma, other histologies, MFH, and sarcoma NOS, respectively (P < 0.0001). Median DSS was 120, 53, not reached, 30, and 13 mo for liposarcoma, leiomyosarcoma, other histologies, MFH, and sarcoma NOS, respectively (P < 0.0001). On multivariate analysis, histologic type was associated with statistically significant differences in both OS and DSS.

CONCLUSIONS

Histologic type is an important predictor of survival in RPSTS.

摘要

背景

组织学分级、切除完整性和转移存在被传统视为预测腹膜后软组织肉瘤（RPSTS）生存的主要因素。我们旨在探讨组织学类型作为 RPSTS 患者预后因素的重要性。

方法

我们从 1988 年至 2004 年的监测、流行病学和最终结果（SEER）数据库中确定了 2337 例 RPSTS 病例。排除年龄<18 岁、仅通过尸检确定、或缺乏组织学证实的 273 例病例后，我们得到了最终的 2064 例患者研究队列。使用 Kaplan-Meier 方法估计总生存率（OS）和疾病特异性生存率（DSS）。使用 Cox 比例风险模型进行多变量分析，调整年龄、性别、种族、组织学类型、组织学分级、肿瘤大小、切除范围和 SEER 总结分期。

结果

在 33 种组织学类型中，平滑肌肉瘤（28.7%）、高分化/去分化脂肪肉瘤（20.3%）、未特指的脂肪肉瘤（11.9%）、恶性纤维组织细胞瘤（MFH-11.0%）和肉瘤 NOS（10.7%）最为常见。分级分布为低级别 24.2%、中级 16%、高级 34.3%和未知 25.5%。85.8%的患者接受了手术，22.8%的患者接受了放疗。中位随访 38 个月时，脂肪肉瘤、平滑肌肉瘤、其他组织学类型、MFH 和肉瘤 NOS 的中位 OS 分别为 78、35、25、18 和 10 个月（P<0.0001）。中位 DSS 分别为 120、53、未达到、30 和 13 个月，用于脂肪肉瘤、平滑肌肉瘤、其他组织学类型、MFH 和肉瘤 NOS（P<0.0001）。多变量分析显示，组织学类型与 OS 和 DSS 均具有显著统计学差异。