Ogura Koichi, Higashi Takahiro, Kawai Akira
Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Division of Health Services Research, Center for Cancer Control and Information Services, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
J Orthop Sci. 2017 Jul;22(4):755-764. doi: 10.1016/j.jos.2017.03.017.
No previous reports to date have characterized the national profiles of soft-tissue sarcomas (STSs). In the present study, we reviewed current practice for STSs in Japan using data from a nationwide organ-specific cancer registry for bone and soft-tissue tumors in Japan, the Bone and Soft Tissue Tumor (BSTT) Registry.
In the registry, we identified 8228 patients with STSs during the period 2006-2012, and extracted data on patient demographics, treatment, and outcome at the last follow-up for each patient. Disease-specific survival was analyzed using the Cox proportional hazards model.
STSs showed a slight male predilection. The age distribution had a single peak in the seventh decade, the proportion of elderly patients aged >60 years being approximately 53%. For most of the histologic subtypes, the most frequent tumor location was the lower extremity, whereas it was the trunk in patients with malignant peripheral nerve sheath tumor, dedifferentiated liposarcoma, and primitive neuroectodermal tumor. Based on data for 2432 patients with STSs, we found significant associations between disease-specific survival and age, sex, histologic subtype, tumor size, tumor depth, tumor location, additional surgery, limb salvage status, and surgical margin; elderly patients showed the poorest disease-specific survival.
Using the BSTT Registry, this study has clarified the epidemiology, treatment, and prognosis of patients with STSs in Japan. Our experiences with the BSTT Registry will be of help to other countries where aging of the population is occurring. Continuous accumulation of clinical data in the BSTT Registry should provide more informative data on STSs, thus improving both the level of medical care offered by clinicians and the outcomes for patients through sharing of such data and promotion of clinical research.
迄今为止，尚无关于软组织肉瘤（STS）全国概况的报道。在本研究中，我们利用日本全国骨与软组织肿瘤器官特异性癌症登记处——骨与软组织肿瘤（BSTT）登记处的数据，回顾了日本目前对STS的诊疗情况。
在该登记处，我们确定了2006年至2012年期间的8228例STS患者，并提取了每位患者的人口统计学、治疗及最后一次随访时的结局数据。采用Cox比例风险模型分析疾病特异性生存率。
STS在男性中略为多见。年龄分布在七十多岁时有一个单峰，60岁以上老年患者的比例约为53%。对于大多数组织学亚型，最常见的肿瘤部位是下肢，而在恶性周围神经鞘瘤、去分化脂肪肉瘤和原始神经外胚层肿瘤患者中，最常见的肿瘤部位是躯干。基于2432例STS患者的数据，我们发现疾病特异性生存率与年龄、性别、组织学亚型、肿瘤大小、肿瘤深度、肿瘤部位、额外手术、保肢状态和手术切缘之间存在显著关联；老年患者的疾病特异性生存率最差。
本研究利用BSTT登记处的数据阐明了日本STS患者的流行病学、治疗及预后情况。我们在BSTT登记处的经验将对其他正在经历人口老龄化的国家有所帮助。BSTT登记处临床数据的持续积累应能提供更多关于STS的信息性数据，从而通过共享此类数据和促进临床研究，提高临床医生提供的医疗水平及患者的治疗效果。
