Faisham Wan Ismail, Mat Saad Arman Zaharil, Alsaigh Laith N, Nor Azman Mat Z, Kamarul Imran Musa, Biswal Biswa M, Bhavaraju Venkata Mk, Salzihan Md Salleh, Hasnan Jaafar, Ezane Aziz M, Ariffin Nasir, Norsarwany Mohamad, Ziyadi Mohamad G, Wan Azman Wan Sulaiman, Halim Ahmad Sukari, Zulmi Wan
Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Reconstructive Sciences Unit, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Asia Pac J Clin Oncol. 2017 Apr;13(2):e104-e110. doi: 10.1111/ajco.12346. Epub 2015 Apr 13.
Osteosarcoma is a highly malignant primary bone tumor. The study aim to evaluate the prognostic factors influencing the survival rate in our center.
This was a retrospective cohort study of all patients treated between January 2005 and December 2010.
We included 163 patients with an age range of 6-59 years (median = 19). The median follow-up was 47 months (range 36-84). The overall survival in patients who completed chemotherapy and surgery (n = 117) was 72% at 2 years and 44% at 5 years. Histologically, 99 (85%) had osteoblastic, 6 (5%) had chondroblastic and 3 (2.5%) had telangiectatic osteosarcoma. Limb salvage surgery was performed in 80 (49%) and 41 (25%) underwent amputation. However, 46 patients (28%) underwent no surgical intervention and incomplete chemotherapy. In total, 38/79 patients had a good chemotherapy response. There was a significantly better survival rate for limb salvage versus amputation. Independent prognostic factors for survival are compliance to treatment and presence of lung metastasis.
The overall survival of osteosarcoma patients was influenced by the presence of pulmonary metastases and compliance to treatment. Histological subtype, different chemotherapy regimens and histological necrosis after chemotherapy did not significantly influence survival. The patients who did not complete treatment had significantly poorer survival.
骨肉瘤是一种高度恶性的原发性骨肿瘤。本研究旨在评估影响本中心患者生存率的预后因素。
这是一项对2005年1月至2010年12月期间所有接受治疗患者的回顾性队列研究。
我们纳入了163例年龄在6至59岁（中位数=19岁）的患者。中位随访时间为47个月（范围36至84个月）。完成化疗和手术的患者（n = 117）的2年总生存率为72%，5年总生存率为44%。组织学上，99例（85%）为成骨细胞型骨肉瘤，6例（5%）为软骨细胞型骨肉瘤，3例（2.5%）为毛细血管扩张型骨肉瘤。80例（49%）患者接受了保肢手术，41例（25%）患者接受了截肢手术。然而，46例患者（28%）未接受手术干预且化疗不完整。总共79例患者中有38例化疗反应良好。保肢手术患者的生存率明显高于截肢患者。生存的独立预后因素是治疗依从性和肺转移的存在。
骨肉瘤患者的总生存率受肺转移的存在和治疗依从性的影响。组织学亚型、不同的化疗方案以及化疗后的组织学坏死对生存率没有显著影响。未完成治疗的患者生存率明显较差。
