中央型常规性软骨肉瘤的临床结果。

Clinical outcome of central conventional chondrosarcoma.

机构信息

IV Department of Orthopaedics, University of Bologna, Istituto Ortopedico Rizzoli, Bologna, Italy.

出版信息

J Surg Oncol. 2012 Dec;106(8):929-37. doi: 10.1002/jso.23173. Epub 2012 May 30.

DOI:10.1002/jso.23173

PMID:22649023

Abstract

INTRODUCTION

Aim of this study was to analyze (1) survival, local recurrence (LR), and metastasis rates between the three histological tumor grades; (2) whether type of treatment and tumor site influenced prognosis for each histologic grade.

METHODS

We retrospectively studied 296 patients with central conventional chondrosarcomas (CS) (87 grade 1, 162 grade 2, and 47 grade 3). The femur was the most common site (91 cases), followed by the pelvis (82) and other less frequent sites. Type of surgery was related with histologic grade. Margins were wide in 222 cases, marginal in 23, and intralesional in 51 cases.

RESULTS

At a mean of 7 years, 201 patients remained continuously NED, 33 were NED after treatment of relapse, 15 were AWD, 35 were died of disease, and 12 of other causes. Survival was 92% at 5 years and 84% at 10 years, significantly influenced by histological grading. In grade 3 CS, two factors influenced survival: type of surgery (resection vs. amputation, P = 0.051) and site (P = 0.039). The two significant factors lost their significance at multivariate analysis.

CONCLUSION

Central conventional CS with low/intermediate grade has a good prognosis, while high-grade tumors have poor outcome. Tumor relapses are strictly related with histologic grade.

摘要

简介

本研究旨在分析：(1) 三种组织学肿瘤分级之间的生存率、局部复发率 (LR) 和转移率；(2) 治疗类型和肿瘤部位是否影响各组织学分级的预后。

方法

我们回顾性研究了 296 例中央型常规软骨肉瘤患者（87 例为 1 级，162 例为 2 级，47 例为 3 级）。最常见的肿瘤部位是股骨（91 例），其次是骨盆（82 例）和其他较少见的部位。手术类型与组织学分级有关。222 例为广泛切除，23 例为边缘切除，51 例为局部切除。

结果

平均随访 7 年后，201 例患者持续无瘤生存，33 例经复发治疗后无瘤生存，15 例疾病稳定，35 例死于疾病，12 例死于其他原因。5 年生存率为 92%，10 年生存率为 84%，组织学分级显著影响生存率。在 3 级 CS 中，有两个因素影响生存：手术类型（切除与截肢，P=0.051）和肿瘤部位（P=0.039）。在多因素分析中，这两个重要因素失去了意义。