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低级别非横纹肌肉瘤软组织肉瘤:儿童期的特殊之处

Low-grade Nonrhabdomyosarcoma Soft Tissue Sarcoma: What is Peculiar for Childhood.

作者信息

Fawzy Mohamed, Sedky Mohamed, ElZomor Hossam, El Sherbiny Magdy, Salama Emad, Mahdy Ahmed

机构信息

Departments of *Pediatric Oncology §Surgical Oncology, National Cancer Institute, Cairo University †Department of Pediatric Oncology, Children Cancer Hospital ‡Department of Pediatrics, National Research Center ∥Department of Pediatrics, Misr Insurance Hospital, Cairo, Egypt.

出版信息

J Pediatr Hematol Oncol. 2016 Nov;38(8):615-621. doi: 10.1097/MPH.0000000000000657.

Abstract

BACKGROUND

Nearly half of soft tissue sarcomas are nonrhabdomyosarcomas (NRSTSs). The low-grade (LG) form comprises a heterogenous group of diseases that rarely metastasize but are known for local recurrence.

AIM OF THE STUDY

The aim of the study was to retrospectively evaluate pediatric LG-NRSTS with regard to demography, survival, and factors affecting outcome in Egyptian patients.

PATIENTS AND METHODS

The study reviewed 66 NRSTS patients who presented to the Pediatric Oncology Department, National Cancer Institute, Cairo University, between January 2008 and December 2013.

RESULTS

Out of the reviewed cases 32 patients had LG tumors and were eligible for analysis. The male to female ratio was 1:1 and the median age was 7.5 years (range, 1 mo to 18 y). Desmoid fibromatosis (N=18) showed frequent local recurrence and nearly half of this group was alive without disease. No recurrence of the disease occurred in the nonfibromatosis group (n=14) and all patients were alive and free of disease. The 5-year overall survival was 88% for the entire group of study patients versus 45% for event-free survival. Tumors >5 cm in diameter and fibromatosis histology subtype were associated with lower EFS.

CONCLUSIONS

LG-NRSTS generally has good prognosis, with overall survival reaching 90%. However, aggressive fibromatosis usually runs a poorer course in the form of high incidence of local recurrence and lower survival rates. This needs to be further assessed in larger prospective studies including novel therapies in addition to the current conventional modalities.

摘要

背景

近一半的软组织肉瘤是非横纹肌肉瘤(NRSTSs)。低级别(LG)形式包括一组异质性疾病,很少发生转移,但以局部复发而闻名。

研究目的

本研究的目的是回顾性评估埃及患者小儿LG-NRSTS的人口统计学、生存率及影响预后的因素。

患者与方法

本研究回顾了2008年1月至2013年12月期间在开罗大学国家癌症研究所儿科肿瘤科就诊的66例NRSTS患者。

结果

在回顾的病例中,32例患者患有LG肿瘤且符合分析条件。男女比例为1:1,中位年龄为7.5岁(范围1个月至18岁)。硬纤维瘤病(N = 18)显示出频繁的局部复发,该组近一半患者存活且无疾病。非纤维瘤病组(n = 14)未出现疾病复发,所有患者均存活且无疾病。研究患者全组的5年总生存率为88%,无事件生存率为45%。直径>5 cm的肿瘤和纤维瘤病组织学亚型与较低的无事件生存率相关。

结论

LG-NRSTS通常预后良好,总生存率达90%。然而,侵袭性纤维瘤病通常病程较差,表现为局部复发率高和生存率低。这需要在更大规模的前瞻性研究中进一步评估,除了当前的传统治疗方式外,还应包括新的治疗方法。

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