Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
J Pediatr Surg. 2013 May;48(5):1020-4. doi: 10.1016/j.jpedsurg.2013.02.018.
The purpose of this study was to determine what factors predict recurrent lung metastatic disease in pediatric oncology patients.
A retrospective review of 50 patients who underwent resection of lung nodules that were positive for metastatic disease from 1998 to 2011 was performed. Risk factors for recurrence were determined by multi-variable logistic regression models.
Fifty pediatric oncology patients underwent resection of discrete lung nodules seen on CT scans during work-up for metastasis or for routine surveillance. Out of this patient cohort, 23 (46%) patients had recurrent disease. The only significant factors that influenced risk of recurrence were original PET positive study (p<0.05) and patients with osteosarcoma (p<0.002). The type of surgical procedure, margins of original resection, race, age, gender, size, or the number of original nodules was not found to be significant.
Patients with osteosarcoma and PET positive disease at original presentation appear to be at the highest risk of recurrent pulmonary metastatic disease. New pulmonary lesions in these patients should undergo biopsy to confirm metastatic disease.
本研究旨在确定哪些因素可预测儿科肿瘤患者肺部转移性疾病的复发。
对 1998 年至 2011 年间接受过肺部结节切除术的 50 例转移性疾病阳性患者进行了回顾性分析。通过多变量逻辑回归模型确定复发的危险因素。
50 例儿科肿瘤患者因 CT 扫描检查发现转移或常规监测而接受肺部离散结节切除术。在该患者队列中，有 23 例（46%）患者出现疾病复发。唯一显著影响复发风险的因素是原始 PET 阳性研究（p<0.05）和骨肉瘤患者（p<0.002）。原始切除术的手术类型、边缘、种族、年龄、性别、大小或原始结节数量均未发现具有显著意义。
在初始表现时 PET 阳性疾病和患有骨肉瘤的患者似乎具有最高的复发性肺转移性疾病风险。对于这些患者的新肺部病变，应进行活检以确认转移性疾病。
