Pruksakorn Dumnoensun, Phanphaisarn Areerak, Arpornchayanon Olarn, Uttamo Nantawat, Leerapun Taninnit, Settakorn Jongkolnee
Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Thailand; Excellence Center in Osteology Research and Training Center (ORTC), Chiang Mai University, Thailand.
Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Thailand.
Cancer Epidemiol. 2015 Dec;39(6):956-63. doi: 10.1016/j.canep.2015.10.016. Epub 2015 Nov 9.
Osteosarcoma is a common and aggressive primary malignant bone tumor occurring in children and adolescents. It is one of the most aggressive human cancers and the most common cause of cancer-associated limb loss. As treatment in Thailand has produced a lower survival rate than in developed countries; therefore, this study identified survival rate and the poor prognostic factors of osteosarcoma in Northern Thailand.
The retrospective cases of osteosarcoma, diagnosis between 1 January 1996 and 31 December 2013, were evaluated. Five and ten year overall survival rates were analyzed using time-to-event analysis. Potential prognostic factors were identified by multivariate regression analysis.
There were 208 newly diagnosed osteosarcomas during that period, and 144 cases met the criteria for analysis. The majority of the osteosarcoma cases (78.5%) were aged 0-24 years. The overall 5- and 10-year survival rates were 37.9% and 33.6%, respectively. Presence of metastasis at initial examination, delayed and against treatment co-operation, and axial skeletal location were identified as independent prognostic factors for survival, with hazard ratios of 4.3, 2.5 and 3.8, and 3.1, respectively.
This osteosarcoma cohort had a relatively poor overall survival rate. The prognostic factors identified would play a critical role in modifying survival rates of osteosarcoma patients; as rapid disease recognition, a better treatment counselling, as well as improving of chemotherapeutic regimens were found to be important in improving the overall survival rate in Thailand.
骨肉瘤是一种常见且侵袭性强的原发性恶性骨肿瘤，发生于儿童和青少年。它是人类最具侵袭性的癌症之一，也是癌症相关肢体缺失的最常见原因。由于泰国的治疗生存率低于发达国家；因此，本研究确定了泰国北部骨肉瘤的生存率及不良预后因素。
对1996年1月1日至2013年12月31日期间诊断的骨肉瘤回顾性病例进行评估。采用事件发生时间分析方法分析5年和10年总生存率。通过多因素回归分析确定潜在的预后因素。
在此期间有208例新诊断的骨肉瘤，144例符合分析标准。大多数骨肉瘤病例（78.5%）年龄在0 - 24岁。5年和10年总生存率分别为37.9%和33.6%。初次检查时存在转移、延迟治疗及不配合治疗以及轴向骨骼部位被确定为生存的独立预后因素，风险比分别为4.3、2.5和3.8以及3.1。
该骨肉瘤队列的总生存率相对较低。所确定的预后因素将在改善骨肉瘤患者生存率方面发挥关键作用；因为快速的疾病识别、更好的治疗咨询以及改进化疗方案对于提高泰国的总生存率很重要。
