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常见和罕见肉瘤组织学亚型的表现和结局:10262 例局限性内脏/软组织肉瘤患者在参考中心治疗的研究。

Presentation and outcome of frequent and rare sarcoma histologic subtypes: A study of 10,262 patients with localized visceral/soft tissue sarcoma managed in reference centers.

机构信息

Department of Medical Oncology, Oscar Lambret Center, Lille, France.

Methodology Clinical Research Platform, Lille French Comprehensive Cancer Center (SIRIC OncoLille), Lille, France.

出版信息

Cancer. 2018 Mar 15;124(6):1179-1187. doi: 10.1002/cncr.31176. Epub 2017 Dec 6.

Abstract

BACKGROUND

The objective of this study was to describe characteristics at diagnosis and outcomes of adults with soft tissue sarcoma.

METHODS

The authors conducted a retrospective multicenter study of 12,262 patients who were treated between January 1980 and 31 December 2013 in French Sarcoma Group centers and enrolled in the "Conticabase." Diagnoses were systematically reviewed by expert pathologists, and entities were classified according to the 2013 World Health Organization classification. Diagnostic characteristics, treatments, and outcomes are described for the entire cohort, for the subgroup of patients with translocation-related sarcomas, and for 9 different histologic subtypes.

RESULTS

The results stressed the magnitude of heterogeneity among adult sarcomas. For example, compared with other sarcomas, translocation-related sarcomas (2143 tumors; 20.8%) were associated with a younger age at presentation (40.6 vs 60.0 years; P < .0001), a low rate of predisposing conditions (0.01% vs 22.3%; P < .0001), a higher rate of lymph node involvement (4.7% vs 1.3%; P < .0001), and a higher rate of synchronous metastasis (11.9% vs 6.7%; P < .001); and complete (R0) resection (41.6% vs 31.9%; P < .0001), receipt of (neo)adjuvant radiation therapy (62.6% vs 42.2%; P < .0001), and receipt of (neo)adjuvant chemotherapy (36.6% vs 22.3%; P < .0001) were significantly more frequent. Overall, translocation-related sarcomas were associated with a lower rate of local relapse (18.1% vs 26.0%; P < .0001) but a higher rate of metastatic relapse (42.0% vs 30.7%; P < .0001).

CONCLUSIONS

Collaborative efforts are urgently needed to better assess the natural history and management options for every histologic subtype of sarcoma. Cancer 2018;124:1179-87. © 2017 American Cancer Society.

摘要

背景

本研究旨在描述成人软组织肉瘤的诊断特征和结局。

方法

作者对 1980 年 1 月至 2013 年 12 月 31 日期间在法国肉瘤研究组中心接受治疗并纳入“Conticabase”的 12262 例患者进行了回顾性多中心研究。诊断由专家病理学家进行系统审查,根据 2013 年世界卫生组织分类对实体进行分类。描述了整个队列、易位相关肉瘤亚组和 9 种不同组织学亚型的诊断特征、治疗方法和结局。

结果

研究结果强调了成人肉瘤之间存在巨大的异质性。例如,与其他肉瘤相比,易位相关肉瘤(2143 例;20.8%)的发病年龄更轻(40.6 岁比 60.0 岁;P<0.0001),发病前疾病的发生率更低(0.01%比 22.3%;P<0.0001),淋巴结受累的发生率更高(4.7%比 1.3%;P<0.0001),同步转移的发生率更高(11.9%比 6.7%;P<0.001);完全(R0)切除(41.6%比 31.9%;P<0.0001)、接受(新)辅助放疗(62.6%比 42.2%;P<0.0001)和(新)辅助化疗(36.6%比 22.3%;P<0.0001)的比例明显更高。总的来说,易位相关肉瘤局部复发率较低(18.1%比 26.0%;P<0.0001),但转移复发率较高(42.0%比 30.7%;P<0.0001)。

结论

迫切需要协作努力,以更好地评估每种肉瘤组织学亚型的自然史和治疗选择。癌症 2018;124:1179-87。© 2017 美国癌症协会。

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