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软骨肉瘤25年治疗期间的发病率、治疗结果及预后因素

Incidence, outcomes and prognostic factors during 25 years of treatment of chondrosarcomas.

作者信息

van Praag Veroniek V M, Rueten-Budde A J, Ho V, Dijkstra P D S, Fiocco M, van de Sande M A J

机构信息

Department of Orthopaedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands.

The Mathematical Institute, Leiden University, Rapenburg 70, 2311 EZ Leiden, The Netherlands.

出版信息

Surg Oncol. 2018 Sep;27(3):402-408. doi: 10.1016/j.suronc.2018.05.009. Epub 2018 May 6.

Abstract

BACKGROUND

There are few studies detailing the incidence, patient outcomes and prognostic factors for chondrosarcomas (CS). Those that do exist have small sample sizes and/or use older datasets. The purpose of this study was to determine the incidence, overall survival (OS) and prognostic factors for OS of CS patients, as well as investigate the efficacy of curettage.

METHODS

We analyzed data of 2186 patients diagnosed with chondrosarcomas between '89-'13 from the Netherlands Cancer Registry. The effect of risk factors on OS was assessed with a multivariate Cox regression. Median Follow-up was determined with reversed Kaplan-Meier. OS was estimated using Kaplan-Meier method.

RESULTS

The relative incidence of CS was 2.88 per million citizens between '89-'96, 4.15 between '96-'04 and 8.78 between '05-'13. Most of the increase in incidence came from atypical cartilaginous tumours/grade I chondrosarcoma (ACT/CS I). The 3-, 5- and 10-years survival were, respectively, 96%, 93% and 88% for ACT/CS I, 82%, 74% and 62% for grade II CS and 38%, 31% and 26% for grade III CS. Prognostics factors significantly associated with OS were age, histological grade, year of diagnosis, tumour location and size.

CONCLUSION

The incidence of CS, and especially ACT/CS I, has increased over time, which could be driven by both an ageing population and increased diagnostic imaging. With the increased number of diagnosed ACT/CS I, the number of preventative curettages of this tumour has also increased. Despite the supposed preventative character of this treatment, the incidence of high-grade CS did not decrease.

摘要

背景

关于软骨肉瘤(CS)的发病率、患者预后及预后因素的详细研究较少。现有的研究样本量小且/或使用的是较旧的数据集。本研究的目的是确定CS患者的发病率、总生存期(OS)及OS的预后因素,并研究刮除术的疗效。

方法

我们分析了荷兰癌症登记处1989年至2013年间诊断为软骨肉瘤的2186例患者的数据。采用多变量Cox回归评估危险因素对OS的影响。采用反向Kaplan-Meier法确定中位随访时间。使用Kaplan-Meier法估计OS。

结果

1989年至1996年间CS的相对发病率为每百万公民2.88例,1996年至2004年间为4.15例,2005年至2013年间为8.78例。发病率的增加主要来自非典型软骨肿瘤/Ⅰ级软骨肉瘤(ACT/CS I)。ACT/CS I的3年、5年和10年生存率分别为96%、93%和88%,Ⅱ级CS为82%、74%和62%,Ⅲ级CS为38%、31%和26%。与OS显著相关的预后因素为年龄、组织学分级、诊断年份、肿瘤位置和大小。

结论

CS,尤其是ACT/CS I的发病率随时间增加,这可能是由人口老龄化和诊断性影像学检查增加共同导致的。随着ACT/CS I诊断数量的增加,该肿瘤预防性刮除术的数量也增加了。尽管该治疗具有所谓的预防性,但高级别CS的发病率并未降低。

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