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脊柱软骨肉瘤患者的预后因素:对单中心98例连续患者的回顾性分析

Prognostic factors of patients with spinal chondrosarcoma: a retrospective analysis of 98 consecutive patients in a single center.

作者信息

Yin Huabin, Zhou Wang, Meng Jia, Zhang Dan, Wu Zhipeng, Wang Ting, Wang Jing, Wang Peng, Shi Xin, Wu Sujia, Zhao Jianning, Xiao Jianru

机构信息

Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.

出版信息

Ann Surg Oncol. 2014 Oct;21(11):3572-8. doi: 10.1245/s10434-014-3745-z. Epub 2014 May 16.

DOI:10.1245/s10434-014-3745-z
PMID:24833099
Abstract

PURPOSE

Chondrosarcoma (CHS) in the spine is relatively rare and minimal information has been published in the literature regarding this subject. The objective of our study was to discuss the factors that may affect outcomes of patients with spinal CHS.

METHODS

Univariate and multivariate analyses were performed to identify prognostic factors for recurrence, distant metastasis, and survival of spinal CHS. T test, χ (2) test and rank sum test were used to analyze a single factor for recurrence and metastasis, while survival rate was estimated using the Kaplan-Meier method. Factors with p values of ≤0.1 were subjected to multivariate analyses by binary logistic regression analyses or Cox regression analyses. p Values of ≤0.05 were considered statistically significant.

RESULTS

A total of 98 patients with spinal CHS were included in the study. The mean follow-up period was 49.7 months (range 6-178). Recurrence was detected in 42 patients after initial surgery in our center, while distant metastasis and death occurred in 24 and 32 cases, respectively. The statistical analyses suggested that pathology grade III was closely related with distant metastasis which was an independent prognostic factor for overall survival. Total en bloc spondylectomy could significantly decrease the risk of recurrence, distant metastasis, and death of patients with spinal CHS.

CONCLUSIONS

Total en bloc spondylectomy could significantly decrease the risk of recurrence and distant metastasis, and meanwhile improve overall survival of spinal CHS. Distant metastasis which was closely associated with pathology grade III was an adverse prognostic factor for overall survival of spinal CHS.

摘要

目的

脊柱软骨肉瘤(CHS)相对罕见,关于该主题的文献报道较少。本研究的目的是探讨可能影响脊柱CHS患者预后的因素。

方法

进行单因素和多因素分析,以确定脊柱CHS复发、远处转移和生存的预后因素。采用t检验、χ²检验和秩和检验分析复发和转移的单一因素,同时采用Kaplan-Meier法估计生存率。p值≤0.1的因素通过二元逻辑回归分析或Cox回归分析进行多因素分析。p值≤0.05被认为具有统计学意义。

结果

本研究共纳入98例脊柱CHS患者。平均随访时间为49.7个月(范围6 - 178个月)。在我们中心,42例患者初次手术后出现复发,24例和32例分别发生远处转移和死亡。统计分析表明,病理Ⅲ级与远处转移密切相关,远处转移是总生存的独立预后因素。全椎体整块切除术可显著降低脊柱CHS患者的复发、远处转移和死亡风险。

结论

全椎体整块切除术可显著降低脊柱CHS的复发和远处转移风险,同时提高总生存率。与病理Ⅲ级密切相关的远处转移是脊柱CHS总生存的不良预后因素。

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