Zhao Jun, Yang Yun
Department of Bone and Soft Tissue Tumor, Cancer Institute and Hospital of Tianjin Medical University, Tianjin 300060, China.
Zhonghua Wai Ke Za Zhi. 2011 Nov;49(11):970-3.
To investigate the outcome of standard treatment in stage III soft tissue sarcomas and the prognostic factors in these patients.
Clinical, pathological, and therapeutic information of 67 patients with stage III soft tissue sarcomas were collected from Tianjin Medical University Cancer Hospital from January 2003 to January 2006. All these patients were treated with the same treatment program. Univariate analysis was performed on surgical margin, tumor sizes, tumor depth, metastasis free interval and neoadjuvant chemotherapy for the main endpoint, overall survival, and second endpoint, distant recurrence free survival (DRFS), the local recurrence rate was also analysed.
Univariate analysis indicated that tumor sizes, depths and metastasis free interval were related to the overall survival. Furthermore, the tumor sizes and the tumor depth were related to DRFS (P < 0.05). However, surgical margin and neoadjuvant chemotherapy showed no effect on the OS and DRFS (P < 0.05). There was no significant difference in local recurrence rate in patients with different surgical margins.
Patients with stage III soft tissue sarcoma might not benefit from wide resection in local control, DRFS, and OS. The tumor size and depth are important prognostic factors for OS. The pulmonary metastasis occurs during adjuvant chemotherapy predicts worse prognosis. Whether or not neoadjuvant chemotherapy improves OS and DRFS needs further prospective study.
探讨Ⅲ期软组织肉瘤标准治疗的疗效及这些患者的预后因素。
收集2003年1月至2006年1月天津医科大学肿瘤医院67例Ⅲ期软组织肉瘤患者的临床、病理和治疗信息。所有这些患者均采用相同的治疗方案。对手术切缘、肿瘤大小、肿瘤深度、无转移间期和新辅助化疗进行单因素分析,以总生存为主要终点,远处无复发生存(DRFS)为次要终点,同时分析局部复发率。
单因素分析表明,肿瘤大小、深度和无转移间期与总生存相关。此外,肿瘤大小和肿瘤深度与DRFS相关(P<0.05)。然而,手术切缘和新辅助化疗对总生存和DRFS无影响(P<0.05)。不同手术切缘患者的局部复发率无显著差异。
Ⅲ期软组织肉瘤患者在局部控制、DRFS和总生存方面可能无法从广泛切除中获益。肿瘤大小和深度是总生存的重要预后因素。辅助化疗期间发生肺转移预示预后较差。新辅助化疗是否能改善总生存和DRFS需要进一步的前瞻性研究。