Willegger Madeleine, Posch Florian, Schieder Sophie, Funovics Philipp Theodor, Scharrer Anke, Brodowicz Thomas, Ay Cihan, Windhager Reinhard, Panotopoulos Joannis
Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Clinical Division of Medical Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
J Orthop Res. 2017 Dec;35(12):2815-2824. doi: 10.1002/jor.23598. Epub 2017 Jun 6.
Recent evidence suggests that common prognostic factors predicting disease progression and survival in soft tissue sarcomas (STS) are not applicable to all STS entities, indicating the need for histotype specific evaluation of new prognosticators. This study aimed at evaluating preoperative serum creatinine, albumin, and the albumin-creatinine ratio (ACR) as markers for survival in patients with malignant fibroblastic and myofibroblastic sarcomas. One hundred and thirty-two patients who underwent sarcoma resection have been included. Statistical analysis comprised uni- and multivariable Cox proportional hazard models, competing risk analysis and Kaplan-Meier estimates. The 5-year overall survival (OS) was estimated at 64.1% (95%CI: 53.7-72.8) and the 5-year sarcoma-specific mortality was 19.9% (95%CI: 12.8-28.1). Elevated serum creatinine levels were significantly associated with an impaired sarcoma-specific survival (SSS) adjusted for tumor stage (subdistribution hazard ratio (SHR) per 1 mg/dl increase: 3.27; 95%CI: 1.87-5.73; p < 0.0001). Low serum albumin levels were associated with a shorter recurrence-free survival (RFS) experience (HR per 10 g/L increase: 0.62; 95%CI: 0.41-0.94; p = 0.024). The ACR emerged as an AJCC-stage-independent prognosticator of SSS (SHR per 1 unit increase: 0.94; 95%CI: 0.90-0.98; p = 0.003). In conclusion, serum albumin and creatinine have been confirmed as predictive biomarkers for disease-specific outcomes in myofibroblastic and fibroblastic sarcomas. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2815-2824, 2017.
近期证据表明，预测软组织肉瘤（STS）疾病进展和生存的常见预后因素并不适用于所有STS实体，这表明需要对新的预后因素进行组织学类型特异性评估。本研究旨在评估术前血清肌酐、白蛋白以及白蛋白-肌酐比值（ACR）作为恶性纤维母细胞性和肌纤维母细胞性肉瘤患者生存标志物的情况。纳入了132例行肉瘤切除术的患者。统计分析包括单变量和多变量Cox比例风险模型、竞争风险分析以及Kaplan-Meier估计。5年总生存率（OS）估计为64.1%（95%CI：53.7 - 72.8），5年肉瘤特异性死亡率为19.9%（95%CI：12.8 - 28.1）。血清肌酐水平升高与经肿瘤分期调整后的肉瘤特异性生存（SSS）受损显著相关（每增加1mg/dl的亚分布风险比（SHR）：3.27；95%CI：1.87 - 5.73；p < 0.0001）。低血清白蛋白水平与无复发生存期（RFS）缩短相关（每增加10g/L的风险比（HR）：0.62；95%CI：0.41 - 0.94；p = 0.024）。ACR成为独立于美国癌症联合委员会（AJCC）分期的SSS预后因素（每增加1个单位的SHR：0.94；95%CI：0.90 - 0.98；p = 0.003）。总之，血清白蛋白和肌酐已被确认为肌纤维母细胞性和纤维母细胞性肉瘤疾病特异性结局的预测生物标志物。©2017骨科学研究协会。由威利期刊公司出版。《矫形外科学研究》35:2815 - 2824，2017年。
