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原发性切除腹膜后软组织肉瘤的预后因素:来自单一亚洲三级中心的分析及Gronchi列线图的外部验证

Prognostic factors of primary resected retroperitoneal soft tissue sarcoma: Analysis from a single asian tertiary center and external validation of gronchi's nomogram.

作者信息

Chou Yi-Sheng, Liu Chun-Yu, Chang Yen-Hwa, King Kuang-Liang, Chen Paul Chih-Hsueh, Pan Chin-Chen, Shen Shu-Huei, Liu Yu-Ming, Lin Alex T L, Chen Kuang-Kuo, Shyr Yi-Ming, Lee Rheun-Chuan, Chao Ta-Chung, Yang Muh-Hwa, Chan Chung-Huang, You Jie-Yu, Yen Chueh-Chuan

机构信息

Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.

School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

J Surg Oncol. 2016 Mar;113(4):355-60. doi: 10.1002/jso.24155. Epub 2016 Jan 8.

DOI:10.1002/jso.24155
PMID:26749009
Abstract

BACKGROUND

Surgery is the potentially curative treatment for retroperitoneal sarcoma (RS), but complete resectability is frequently a challenge. This study aimed to characterize the clinical features, prognostic factors and treatment outcomes.

METHODS

A cohort of 144 patients with RS was surveyed retrospectively from January 1st, 2000 to July 30th, 2011. The prognostic influence of clinicopathological characteristics as well as treatments on local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS), were examined by univariate and multivariate analyses. A histology-specific nomogram developed by Gronchi et al was used for validation.

RESULTS

Liposarcoma, leiomyosarcoma, and malignant peripheral sheath tumor (MPNST) were the most common histologies (70%). Multivariate analysis revealed FNCLCC tumor grade was the most significant prognostic factor for OS (P = 0.001) and DMFS (P < 0.001) and complete resection was the only significant prognostic factor for LRFS (P = 0.043). Incomplete resection of grade 3 tumor was significantly associated with a worse OS. Despite some differences in characteristics between our patients and Gronchi's cohort, external validation of Gronchi's nomogram demonstrated excellent concordance in predicting survival.

CONCLUSIONS

Our study demonstrated tumor grade and surgical margins had significant prognostic influence and the Gronchi's nomogram has an excellent applicability in predicting survival of STS patients. J. Surg. Oncol. 2016;113:355-360. © 2016 Wiley Periodicals, Inc.

摘要

背景

手术是腹膜后肉瘤(RS)潜在的治愈性治疗方法,但实现完全可切除性常常是一项挑战。本研究旨在描述其临床特征、预后因素及治疗结果。

方法

回顾性调查了2000年1月1日至2011年7月30日期间的144例RS患者队列。通过单因素和多因素分析,研究临床病理特征以及治疗对无局部复发生存期(LRFS)、无远处转移生存期(DMFS)和总生存期(OS)的预后影响。使用Gronchi等人开发的组织学特异性列线图进行验证。

结果

脂肪肉瘤、平滑肌肉瘤和恶性外周神经鞘瘤(MPNST)是最常见的组织学类型(70%)。多因素分析显示,法国国立癌症中心(FNCLCC)肿瘤分级是OS(P = 0.001)和DMFS(P < 0.001)最显著的预后因素,而完全切除是LRFS唯一显著的预后因素(P = 0.043)。3级肿瘤的不完全切除与较差的OS显著相关。尽管我们的患者与Gronchi队列在特征上存在一些差异,但Gronchi列线图的外部验证在预测生存方面显示出极好的一致性。

结论

我们的研究表明肿瘤分级和手术切缘具有显著的预后影响,并且Gronchi列线图在预测软组织肉瘤(STS)患者生存方面具有出色的适用性。《外科肿瘤学杂志》2016年;113:355 - 360。© 2016威利期刊公司

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