The Royal Orthopaedic Hospital, Oncology Service, Bristol Road South, Birmingham, UK.
Bone Joint J. 2013 Aug;95-B(8):1139-43. doi: 10.1302/0301-620X.95B8.31379.
We evaluated the risk of late relapse and further outcome in patients with soft-tissue sarcomas who were alive and event-free more than five years after initial treatment. From our database we identified 1912 patients with these pathologies treated between 1980 and 2006. Of these 1912 patients, 603 were alive and event-free more than five years after initial treatment and we retrospectively reviewed them. The mean age of this group was 48 years (4 to 94) and 340 were men. The mean follow-up was 106 months (60 to 336). Of the original cohort, 582 (97%) were alive at final follow-up. The disease-specific survival was 96.4% (95% confidence interval (CI) 94.4 to 98.3) at ten years and 92.9% (95% CI 89 to 96.8) at 15 years. The rate of late relapse was 6.3% (38 of 603). The ten- and 15-year event-free rates were 93.2% (95% CI 90.8 to 95.7) and 86.1% (95% CI 80.2 to 92.1), respectively. Multivariate analysis showed that tumour size and tumour grade remained independent predictors of events. In spite of further treatment, 19 of the 38 patients died of sarcoma. The three- and five-year survival rates after the late relapse were 56.2% (95% CI 39.5 to 73.3) and 43.2% (95% CI 24.7 to 61.7), respectively, with a median survival time of 46 months. Patients with soft-tissue sarcoma, especially if large, require long-term follow-up, especially as they have moderate potential to have their disease controlled.
我们评估了初始治疗五年后仍存活且无事件的软组织肉瘤患者的晚期复发风险和进一步的转归。从我们的数据库中,我们确定了 1912 名在 1980 年至 2006 年期间接受治疗的软组织肉瘤患者。在这 1912 名患者中,有 603 名患者在初始治疗五年后仍存活且无事件,我们对他们进行了回顾性研究。该组患者的平均年龄为 48 岁(4 至 94 岁),其中 340 名为男性。平均随访时间为 106 个月(60 至 336 个月)。在原始队列中,582 名(97%)患者在最终随访时存活。疾病特异性生存率为 10 年时为 96.4%(95%置信区间 94.4%至 98.3%),15 年时为 92.9%(95%置信区间 89%至 96.8%)。晚期复发率为 6.3%(38 例)。10 年和 15 年的无事件生存率分别为 93.2%(95%置信区间 90.8%至 95.7%)和 86.1%(95%置信区间 80.2%至 92.1%)。多变量分析显示,肿瘤大小和肿瘤分级仍然是事件的独立预测因素。尽管进行了进一步的治疗,38 例患者中有 19 例死于肉瘤。晚期复发后的 3 年和 5 年生存率分别为 56.2%(95%置信区间 39.5%至 73.3%)和 43.2%(95%置信区间 24.7%至 61.7%),中位生存时间为 46 个月。软组织肉瘤患者,尤其是肿瘤较大的患者,需要长期随访,尤其是因为他们有一定的中度潜力可以控制疾病。