Urakawa Hiroshi, Tsukushi Satoshi, Arai Eisuke, Kozawa Eiji, Futamura Naohisa, Ishiguro Naoki, Nishida Yoshihiro
Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi, Japan.
Am J Clin Oncol. 2015 Jun;38(3):266-71. doi: 10.1097/COC.0b013e318295aea2.
The association of symptom duration with survival remains controversial in soft-tissue sarcoma (STS).
We determined whether the length from initial symptoms to specialist consultation affects prognosis in STSs. We retrospectively reviewed 152 primary STS patients (with 142 non-small round cell sarcomas) who consulted our specialist hospital. The factors that affected the length of the period from the initial symptoms to specialist consultation and the length of the delay at the clinic before specialist hospital referral were investigated. The relation between the length of the period from symptom onset and overall survival was also analyzed.
Unplanned excision and superficial tumor were significantly associated with increasing duration from the initial symptoms to specialist hospital referral. Multivariate analysis revealed that tumors over 5 cm (P=0.002 and 0.005) and symptoms within 6 months (P=0.017 and 0.016) were independent poor prognostic factors of overall survival among the pretreatment factors when analyzing all and non-small round cell STSs.
This is a first report to show the independent prognostic role of symptom duration in STSs on multivariate analysis. Considering the impact of symptom duration on survival in these heterogenous tumors, careful follow-up and consideration of treatment are necessary for patients with short symptom duration.
在软组织肉瘤(STS)中,症状持续时间与生存率之间的关联仍存在争议。
我们确定了从初始症状出现到专科会诊的时长是否会影响STS的预后。我们回顾性分析了152例在我院专科就诊的原发性STS患者(其中142例为非小圆细胞肉瘤)。研究了影响从初始症状到专科会诊时长以及在转诊至专科医院之前在诊所延误时长的因素。还分析了从症状出现到总生存期的时长之间的关系。
计划外切除和浅表肿瘤与从初始症状到转诊至专科医院的时长增加显著相关。多因素分析显示,在分析所有STS和非小圆细胞STS时,肿瘤直径超过5 cm(P = 0.002和0.005)以及症状出现6个月内(P = 0.017和0.016)是治疗前因素中总生存期的独立不良预后因素。
这是首份在多因素分析中显示症状持续时间在STS中具有独立预后作用的报告。考虑到症状持续时间对这些异质性肿瘤生存的影响,对于症状持续时间短的患者,有必要进行仔细的随访并考虑治疗方案。