Pakos E E, Grimer R J, Peake D, Spooner D, Carter S R, Tillman R M, Abudu S, Jeys L
University of Ioannina, P.O. Box 1186, 45110 Ioannina, Greece.
J Bone Joint Surg Br. 2011 Sep;93(9):1271-8. doi: 10.1302/0301-620X.93B9.27166.
We aimed to identify the incidence, outcome and prognostic factors associated with spindle cell sarcomas of bone (SCSB). We studied 196 patients with a primary non-metastatic tumour treated with the intent to cure. The results were compared with those of osteosarcoma patients treated at our hospital during the same period. The overall incidence of SCSB was 7.8% of all patients with a primary bone sarcoma. The five- and ten-year survival rates were 67.0% and 60.0%, respectively, which were better than those of patients with osteosarcoma treated over the same period. All histological subtypes had similar outcomes. On univariate analysis, factors that were significantly associated with decreased survival were age > 40 years, size > 8 cm, the presence of a pathological fracture, amputation, involved margins and a poor response to pre-operative chemotherapy. Multivariate analyses showed that age > 65 years, amputation and involved margins were all statistically significant prognostic factors. Involved margins and poor response to pre-operative chemotherapy were associated with an increased risk of local recurrence. SCSB has a better prognosis than osteosarcoma when matched for age. Most prognostic factors for osteosarcoma also seem to apply to SCSB. Patients with SCSB should be treated in the same way as patients of the same age with osteosarcoma.
我们旨在确定骨梭形细胞肉瘤（SCSB）的发病率、结局及预后因素。我们研究了196例接受根治性治疗的原发性非转移性肿瘤患者。将结果与同期在我院接受治疗的骨肉瘤患者的结果进行比较。SCSB的总体发病率占所有原发性骨肉瘤患者的7.8%。五年和十年生存率分别为67.0%和60.0%，优于同期接受治疗的骨肉瘤患者。所有组织学亚型的结局相似。单因素分析显示，与生存率降低显著相关的因素包括年龄>40岁、肿瘤大小>8 cm、存在病理性骨折、截肢、切缘阳性以及对术前化疗反应不佳。多因素分析表明，年龄>65岁、截肢和切缘阳性均为具有统计学意义的预后因素。切缘阳性和对术前化疗反应不佳与局部复发风险增加相关。在年龄匹配时，SCSB的预后优于骨肉瘤。大多数骨肉瘤的预后因素似乎也适用于SCSB。SCSB患者应与同龄骨肉瘤患者接受相同的治疗。
