Tsuda Yusuke, Ogura Koichi, Hakozaki Michiyuki, Kikuta Kazutaka, Ae Keisuke, Tsuchiya Hiroyuki, Iwata Shintaro, Ueda Takafumi, Kawano Hirotaka, Kawai Akira
Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.
J Surg Oncol. 2017 May;115(6):760-767. doi: 10.1002/jso.24567.
This study aimed to elucidate the clinical features and prognostic factors of mesenchymal chondrosarcoma (MCS) and investigate optimal treatment strategies.
Data from 57 patients with MCS were collected from a Japanese Musculoskeletal Oncology Group (JMOG) and retrospectively analyzed.
Data from 29 males and 28 females were collected. Primary tumor sites were the head and neck (7 patients), trunk (35 patients), and extremities (15 patients). The tumors originating in the trunk were significantly associated with a worse OS compared with those originating at the other sites in all patients and those with localized disease (P = 0.020 and P = 0.019, respectively). In patients with localized disease, the tumors originating in the head and neck were significantly associated with better OS and MFS compared with those originating in the trunk (P = 0.024 and P = 0.014, respectively). Positive surgical margin was significantly correlated with the worse LRFS (P = 0.018). Adjuvant chemotherapy exhibited a clear trend toward improved OS when MCS was localized in the trunk or extremities (P = 0.057).
Adequate surgery is considered to be the mainstay of treatment for localized MCS. Prognosis was different depending on the site of tumor origin.
本研究旨在阐明间叶性软骨肉瘤(MCS)的临床特征和预后因素,并探讨最佳治疗策略。
从日本肌肉骨骼肿瘤学组(JMOG)收集57例MCS患者的数据并进行回顾性分析。
收集了29例男性和28例女性的数据。原发肿瘤部位为头颈部(7例)、躯干(35例)和四肢(15例)。在所有患者以及局限性疾病患者中,起源于躯干的肿瘤与较差的总生存期(OS)显著相关,分别与起源于其他部位的肿瘤相比(P = 0.020和P = 0.019)。在局限性疾病患者中,起源于头颈部的肿瘤与起源于躯干的肿瘤相比,总生存期(OS)和无复发生存期(MFS)显著更好(分别为P = 0.024和P = 0.014)。手术切缘阳性与较差的局部复发无病生存期(LRFS)显著相关(P = 0.018)。当MCS局限于躯干或四肢时,辅助化疗显示出总生存期(OS)改善的明显趋势(P = 0.057)。
充分的手术被认为是局限性MCS治疗的主要手段。预后因肿瘤起源部位而异。