未计划治疗的原发性骨肉瘤患者的预后。

The prognosis of patients with primary osteosarcoma who have undergone unplanned therapy.

机构信息

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan.

出版信息

Jpn J Clin Oncol. 2011 Nov;41(11):1244-50. doi: 10.1093/jjco/hyr138. Epub 2011 Oct 11.

DOI:10.1093/jjco/hyr138

PMID:21994209

Abstract

OBJECTIVE

For diagnosing osteosarcoma correctly, a combination of clinical, radiological and histological examinations is required. Erroneous treatment may cause local contamination and systemic seeding in patients. The purpose of this study was to compare outcomes of planned and unplanned treatment for osteosarcoma.

METHODS

A retrospective review of patients with high-grade osteosarcoma who received appropriate surgical treatment and chemotherapy (n = 134) and those who were misdiagnosed and received unplanned surgery (n = 16) between July 1995 and February 2005.

RESULTS

Patients who received unplanned treatment were older (mean age: 29.7 vs. 19.7 years; P = 0.003) and had a smaller mean tumor volume (119 vs. 280 ml; P = 0.015). The 5-year survival rate was not statistically different between the groups. Patients who had unplanned treatment had a higher local recurrence rate (43.8 vs. 17.9%; P = 0.024) and a shorter mean time for recurrence (11.9 vs. 20.8 months; P = 0.036). Furthermore, in patients who underwent unplanned treatment, lung metastases occurred earlier (6.1 vs. 16.2 months P = 0.021) and the final limb salvage rate was less (68.7 vs. 87.3%; P < 0.001).

CONCLUSIONS

Unplanned treatment for high-grade osteosarcoma can result in failure of local control and earlier systemic metastases.

摘要

目的

为了正确诊断骨肉瘤，需要结合临床、影像学和组织学检查。错误的治疗可能会导致患者局部污染和全身播散。本研究旨在比较计划内和计划外治疗骨肉瘤的结果。

方法

回顾性分析 1995 年 7 月至 2005 年 2 月期间接受适当手术治疗和化疗的高级别骨肉瘤患者（n=134）和误诊并接受非计划手术的患者（n=16）。

结果

接受非计划治疗的患者年龄较大（平均年龄：29.7 岁 vs. 19.7 岁；P=0.003），肿瘤体积较小（平均体积：119 毫升 vs. 280 毫升；P=0.015）。两组患者的 5 年生存率无统计学差异。接受非计划治疗的患者局部复发率较高（43.8% vs. 17.9%；P=0.024），复发时间较短（11.9 个月 vs. 20.8 个月；P=0.036）。此外，接受非计划治疗的患者中，肺转移发生更早（6.1 个月 vs. 16.2 个月；P=0.021），最终保肢率较低（68.7% vs. 87.3%；P<0.001）。