Sun Hui-Hui, Chen Xiang-Yang, Cui Jia-Qu, Zhou Zhao-Ming, Guo Kai-Jin
Department of Orthopedic Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Jiangsu, China.
Department of Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany.
Medicine (Baltimore). 2018 Sep;97(39):e12636. doi: 10.1097/MD.0000000000012636.
This study was aimed to reveal the changes in survival rates and prognostic factors to survival of chondroblastic osteosarcoma (COS).Patients from the Surveillance, Epidemiology, and End Results (SEER) database were retrieved. Kaplan-Meier survival analysis and Cox proportional hazard model were used during analysis.There were significant differences on overall survival between subtypes of osteosarcoma (P < .001*). Overall survival of COS did not change significantly during last forty years (P = .610), and cancer-specific survival increased to a plateau in 1980s and then remained stable (P = .058). Younger onset age, patients of white race, well and moderately differentiated tumors, and surgery independently predicted better overall (Hazard ratio [HR]: 1.034, P < .001*; HR: 0.538, P = .004*; HR: 0.240, P = .020* and HR: 0.350, P < .001*, respectively) and cancer-specific (HR: 1.031, P = .002*; HR: 0.592, P = .036*; HR: 0.098, P = .027* and HR: 0.253, P < .001*, respectively) survival. Metastasis at diagnosis independently predicted worse overall (HR: 3.108, P < .001*) and cancer-specific (HR: 4.26, P < .001*) survival compared to no metastasis.Younger onset age, white race, well and moderately differentiated tumors, no metastasis at diagnosis and surgical resection can independently predict better overall and cancer-specific survival of COS.
本研究旨在揭示软骨母细胞性骨肉瘤(COS)生存率的变化及生存的预后因素。检索了监测、流行病学和最终结果(SEER)数据库中的患者。分析过程中采用了Kaplan-Meier生存分析和Cox比例风险模型。骨肉瘤各亚型的总生存率存在显著差异(P<0.001*)。COS的总生存率在过去40年中无显著变化(P=0.610),癌症特异性生存率在20世纪80年代上升至平台期,然后保持稳定(P=0.058)。发病年龄较小、白种人患者、高分化和中分化肿瘤以及手术分别独立预测较好的总生存率(风险比[HR]:1.034,P<0.001*;HR:0.538,P=0.004*;HR:0.240,P=0.020*;HR:0.350,P<0.001*)和癌症特异性生存率(HR:1.031,P=0.002*;HR:0.592,P=0.036*;HR:0.098,P=0.027*;HR:0.253,P<0.001*)。与无转移相比,诊断时发生转移独立预测较差的总生存率(HR:3.108,P<0.001*)和癌症特异性生存率(HR:4.26,P<0.001*)。发病年龄较小、白种人、高分化和中分化肿瘤、诊断时无转移以及手术切除可独立预测COS较好的总生存率和癌症特异性生存率。