Stihsen C, Panotopoulos J, Puchner S E, Sevelda F, Kaider A, Windhager R, Funovics P T
Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Bone Joint J. 2017 May;99-B(5):686-696. doi: 10.1302/0301-620X.99B5.BJJ-2016-0761.R1.
Few studies dealing with chondrosarcoma of the pelvis are currently available. Different data about the overall survival and prognostic factors have been published but without a detailed analysis of surgery-related complications. We aimed to analyse the outcome of a series of pelvic chondrosarcomas treated at a single institution, with particular attention to the prognostic factors. Based on a competing risk model, our objective was to identify risk factors for the development of complications.
In a retrospective single-centre study, 58 chondrosarcomas (26 patients alive, 32 patients dead) of the pelvis were reviewed. The mean follow-up was 13 years (one week to 23.1 years).
A total of 26 patients (45%) were alive and 32 patients (55%) had died. Overall survival was 76%, 55% and 45% at one, five and ten years post-operatively, respectively. In a competing risk model the cumulative risk of the development of a surgery-related complication was 64% at six months and 69% at one year, post-operatively, respectively. Endoprosthetic reconstruction was a significant risk factor for the development of complications (p = 0.006). Complications were not significantly related to age or the location or grade of the tumour (p = 0.823, p = 0.976, p = 0.858). The development of complications did not have a negative effect on survival (p = 0.147).
This is the first study with competing risk analysis of surgery-related complications in patients with a pelvic chondrosarcoma. The surgery in these patients remains prone to complications. Endoprosthetic reconstruction significantly increases the risk of the development of complications (p = 0.006). A competing risk model showed that the development of complications does not have a negative influence on overall survival (p = 0.147). An aggressive, surgical resection with the goal of achieving wide margins whenever possible remains the mainstay of treatment. Cite this article: 2017;99-B:686-96.
目前有关骨盆软骨肉瘤的研究较少。已发表了关于总生存率和预后因素的不同数据，但未对手术相关并发症进行详细分析。我们旨在分析在单一机构治疗的一系列骨盆软骨肉瘤的结果，特别关注预后因素。基于竞争风险模型，我们的目标是确定并发症发生的风险因素。
在一项回顾性单中心研究中，对58例骨盆软骨肉瘤（26例存活患者，32例死亡患者）进行了评估。平均随访时间为13年（1周至23.1年）。
共有26例患者（45%）存活，32例患者（55%）死亡。术后1年、5年和10年的总生存率分别为76%、55%和45%。在竞争风险模型中，术后6个月和1年手术相关并发症发生的累积风险分别为64%和69%。人工关节置换重建是并发症发生的一个重要风险因素（p = 0.006）。并发症与年龄、肿瘤位置或分级无显著相关性（p = 0.823，p = 0.976，p = 0.858）。并发症的发生对生存率没有负面影响（p = 0.147）。
这是第一项对骨盆软骨肉瘤患者手术相关并发症进行竞争风险分析的研究。这些患者的手术仍容易发生并发症。人工关节置换重建显著增加了并发症发生的风险（p = 0.006）。竞争风险模型显示，并发症的发生对总生存率没有负面影响（p = 0.147）。积极的、以尽可能实现广泛切缘为目标的手术切除仍然是主要的治疗方法。引用本文：2017；99 - B：686 - 96。
