Dear Rachel F, Kelly Patrick J, Wright Gavin M, Stalley Paul, McCaughan Brian C, Tattersall Martin H N
Sydney Medical School, Room 391, Blackburn Building, D06, University of Sydney, Sydney, NSW 2006, Australia.
Asia Pac J Clin Oncol. 2012 Sep;8(3):292-302. doi: 10.1111/j.1743-7563.2012.01521.x. Epub 2012 Apr 25.
The aim of this study is to analyze the prognostic factors for overall and relapse-free survival that may help select patients for pulmonary metastasectomy and inform their prognosis.
From 1978 to 2008 130 patients underwent pulmonary metastasectomy for bone (osteosarcoma, chondrosarcoma and Ewing's sarcoma) and soft tissue sarcomas. Outcome measures analyzed were time to death and relapse and Cox regression models analyzed the association of prognostic factors.
In total 114 patients were analyzed. The 5-year post-metastasectomy overall survival rate was 43%. The 5-year relapse-free survival rate was 19%. In the multivariate analysis, an incomplete surgical resection (P = 0.02) was associated with an increased risk of death. There was weak evidence that a diameter of the largest resected metastasis ≥ 1.8 cm (P = 0.07) and a disease-free interval of ≤ 18 months (P = 0.08) were associated with an increased risk of death.
Poor prognostic factors for overall survival after a pulmonary metastasectomy are an incomplete surgical resection, a large diameter of the biggest resected metastasis and a short disease-free interval. The role of perioperative chemotherapy is uncertain.
本研究旨在分析总生存和无复发生存的预后因素，以帮助选择适合行肺转移瘤切除术的患者并告知其预后情况。
1978年至2008年期间，130例患者因骨（骨肉瘤、软骨肉瘤和尤因肉瘤）及软组织肉瘤行肺转移瘤切除术。分析的结局指标为死亡和复发时间，Cox回归模型分析预后因素的相关性。
共分析了114例患者。转移瘤切除术后5年总生存率为43%。5年无复发生存率为19%。多因素分析中，手术切除不完全（P = 0.02）与死亡风险增加相关。有微弱证据表明，最大切除转移瘤直径≥1.8 cm（P = 0.07）和无病间期≤18个月（P = 0.08）与死亡风险增加相关。
肺转移瘤切除术后总生存的不良预后因素为手术切除不完全、最大切除转移瘤直径大及无病间期短。围手术期化疗的作用尚不确定。
