Lopez-Oliva C L L, Yun J Y, Kim H-S, Han I
Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 03080, South Korea.
Eur J Surg Oncol. 2016 Apr;42(4):567-73. doi: 10.1016/j.ejso.2016.01.014. Epub 2016 Jan 29.
Understanding the incidence and characteristics of multiple primary malignancies (MPM) has implications for guiding appropriate treatment and surveillance of extremity soft tissue sarcoma (STS).
We sought to examine the incidence of MPM in STS (MPM-STS), and compare their clinicopathologic characteristics and survival to those with STS only.
585 patients who underwent surgery for extremity STS were reviewed. Logistic regression analyses to identify factors contributing to the development of MPMs and a 1:2 matched case-control analysis to compare survival outcome were performed.
Of the 585 patients analyzed, 34 (6%) with MPM were identified. On univariate logistic regression analysis, older age (>49 years) at STS diagnosis (p = 0.008) and histologic types of undifferentiated pleomorphic sarcoma or myxofibrosarcoma (p = 0.033) were significant. In multivariate analysis, only older age at STS diagnosis remained significant (OR = 2.5, p = 0.029). Cancer-specific survival of the MPM-STS group was significantly lower than that of the STS-only group (p = 0.031). However, there was no significant difference in STS-specific survival between the two groups (p = 0.208).
Our study suggests that MPM is not uncommon in extremity STS and older age at STS diagnosis is associated with risk of MPM. Prognosis of STS in the MPM-STS group seems similar to that of the STS-only group.
了解多原发性恶性肿瘤(MPM)的发病率和特征对于指导肢体软组织肉瘤(STS)的适当治疗和监测具有重要意义。
我们试图研究STS中MPM(MPM-STS)的发病率,并将其临床病理特征和生存率与仅患有STS的患者进行比较。
回顾了585例行肢体STS手术的患者。进行逻辑回归分析以确定导致MPM发生的因素,并进行1:2匹配的病例对照分析以比较生存结果。
在分析的585例患者中,有34例(6%)被确定为患有MPM。单因素逻辑回归分析显示,STS诊断时年龄较大(>49岁)(p = 0.008)以及未分化多形性肉瘤或黏液纤维肉瘤的组织学类型(p = 0.033)具有统计学意义。多因素分析中,只有STS诊断时年龄较大仍具有统计学意义(OR = 2.5,p = 0.029)。MPM-STS组的癌症特异性生存率显著低于仅患有STS的组(p = 0.031)。然而,两组之间STS特异性生存率没有显著差异(p = 0.208)。
我们的研究表明,MPM在肢体STS中并不罕见,STS诊断时年龄较大与MPM风险相关。MPM-STS组中STS的预后似乎与仅患有STS的组相似。