Weiss Kurt R, Biau David J, Bhumbra Rej, Griffin Anthony M, Blackstein Martin E, Chung Peter, Catton Charles, O'Sullivan Brian, Ferguson Peter C, Wunder Jay S
Musculoskeletal Oncology Division, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Sarcoma. 2011;2011:395180. doi: 10.1155/2011/395180. Epub 2011 Nov 24.
Introduction. Ewing's sarcomas (EWSs) of bone and soft tissue are neuroectodermal tumors that affect both axial and appendicular locations. We hypothesized that axial location predicted poor outcome in EWS patients. Materials and Methods. Sixty-seven patients (57 with bone EWS and 10 with soft tissue EWS) were identified from our database. Thirty-four (51%) had axial EWS and 33 (49%) had appendicular EWS. Statistical analyses identified predictors of poor outcome. Results and Discussion. Axial location, large size, metastases at presentation, lack of definitive treatment, and positive surgical margins all correlated with poor outcome in univariate analysis. In multivariate analysis, axial location still predicted poor outcome when adjusted for pretreatment variables. Axial location was not statistically predictive of poor outcome when adjusted for treatment variables. Conclusions. Anatomic location has a negative effect on outcome in EWS that cannot be completely explained by pretreatment or treatment factors. Additional studies are required to determine if there is a biologic difference between axial and appendicular EWS.
引言。骨与软组织的尤因肉瘤（EWS）是一种神经外胚层肿瘤，可累及轴位和附属部位。我们推测轴位病变预示着EWS患者预后不良。材料与方法。从我们的数据库中识别出67例患者（57例骨EWS和10例软组织EWS）。34例（51%）有轴位EWS，33例（49%）有附属部位EWS。统计分析确定了预后不良的预测因素。结果与讨论。在单因素分析中，轴位病变、肿瘤体积大、初诊时出现转移、缺乏确定性治疗以及手术切缘阳性均与预后不良相关。在多因素分析中，校正预处理变量后，轴位病变仍预示着预后不良。校正治疗变量后，轴位病变对预后不良无统计学预测意义。结论。解剖部位对EWS的预后有负面影响，这不能完全由预处理或治疗因素来解释。需要进一步研究以确定轴位EWS和附属部位EWS之间是否存在生物学差异。
