局限性经典型骨外骨肉瘤的存活率高于轴外非经典型。
The extremity localized classic osteosarcomas have better survival than the axial non-classics.
机构信息
Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Department of 7th Surgery, Guangdong 999 Brain Hospital, Guangzhou, 510510, China.
出版信息
World J Surg Oncol. 2018 Feb 23;16(1):39. doi: 10.1186/s12957-018-1344-3.
BACKGROUND
Osteosarcoma is one of the most malignant primary bone cancers, while is rarely reported in China. Of note, very few data of prognosis has been documented in this region. Thus, we carried a retrospective study to identify prognostic factors and to analyze outcomes in patients of both classic and non-classic high-grade osteosarcomas. Classic osteosarcoma is defined as of high-grade histology, age below 40 years, with extremity localized primary tumor, and without detectable metastasis at primary diagnosis.
METHODS
A total of 98 patients (68 classic and 30 non-classic) aged from 4 to 64 years old were diagnosed as high-grade osteosarcoma from 2008 to 2015 in Nanfang Hospital, Guangzhou, China. Univariate and multivariate analyses were performed to identify the independent predictors for overall survival and event-free survival. Kaplan-Meier method was used for survival analysis.
RESULTS
The median overall survival was 117 vs. 21 months, and the median event-free survival was 31 vs. 6 months in classic and non-classic osteosarcoma, respectively. The most frequently found tumor site was around the knee. The classic osteosarcoma had better overall survival and event-free survival than the non-classics. Tumor site and primary metastasis were found to be associated with overall survival and event-free survival in the univariate analysis. In the multivariate Cox regression analysis, tumor site and primary metastasis were each verified as independent prognostic factors. However, no similar result was found in elevated serum alkaline phosphatase or lactate dehydrogenase. Amputation or limb salvage surgery had no significant effect on overall survival and event-free survival in the extremity osteosarcomas. Classic osteosarcomas with extremity tumor site and free of primary metastasis exhibited better overall survival and event-free survival, while the axial and metastatic non-classics exhibited the worse.
CONCLUSIONS
The extremity classic osteosarcomas have better survivals than the axial non-classic cases. Amputation and limb salvage surgery make no significant change in overall survival and event-free survival in the extremity osteosarcomas.
TRIAL REGISTRATION
Nanfang2013071; Date of registration: 7 September 2013 (retrospectively registered).
背景
骨肉瘤是最恶性的原发性骨癌之一，在中国很少见。值得注意的是，该地区几乎没有预后数据的记录。因此，我们进行了一项回顾性研究，以确定预后因素，并分析经典和非经典高级骨肉瘤患者的结局。经典骨肉瘤定义为高级组织学，年龄<40 岁，四肢局限性原发性肿瘤，且在原发性诊断时无检测到转移。
方法
2008 年至 2015 年，中国广州南方医院共诊断出 98 例（68 例经典型和 30 例非经典型）年龄在 4 至 64 岁的高级骨肉瘤患者。进行单因素和多因素分析以确定总生存和无事件生存的独立预测因素。使用 Kaplan-Meier 法进行生存分析。
结果
经典骨肉瘤的中位总生存期为 117 个月，非经典骨肉瘤的中位总生存期为 21 个月；经典骨肉瘤的中位无事件生存期为 31 个月，非经典骨肉瘤的中位无事件生存期为 6 个月。最常见的肿瘤部位在膝关节周围。经典骨肉瘤的总生存和无事件生存均优于非经典型。肿瘤部位和原发性转移在单因素分析中与总生存和无事件生存相关。在多因素 Cox 回归分析中，肿瘤部位和原发性转移均被验证为独立的预后因素。然而，在血清碱性磷酸酶或乳酸脱氢酶升高中未发现类似结果。在肢体骨肉瘤中，截肢或保肢手术对总生存和无事件生存没有显著影响。经典型骨肉瘤，肿瘤位于四肢，无原发性转移，总生存和无事件生存较好，而轴性和转移性非经典型骨肉瘤则较差。
结论
四肢经典型骨肉瘤的生存优于轴性非经典型病例。截肢和保肢手术在肢体骨肉瘤中对总生存和无事件生存没有显著影响。
试验注册
Nanfang2013071；注册日期：2013 年 9 月 7 日（回顾性注册）。
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