Chan Chung Ming, Lindsay Adam D, Spiguel Andre R V, Gibbs C Parker, Scarborough Mark T
Division of Orthopaedic Oncology, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA.
Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.
Sarcoma. 2018 Sep 27;2018:8631237. doi: 10.1155/2018/8631237. eCollection 2018.
Periosteal osteosarcoma is a rare surface-based variant with a lower propensity to metastasis and better prognosis than conventional osteosarcoma. The literature supporting survival benefit with adjuvant chemotherapy is lacking. Our institutional practice is for chemotherapy to be offered to patients with high-grade disease.
We conducted a retrospective cohort study of patients managed for periosteal osteosarcoma from 1970 to 2015 analyzing the survival outcomes and assessing for any relationship of survival to patient- or treatment-related factors. 18 patients were included. The study population presented at a mean of 20.8 years and was followed for a mean of 10.7 years. Factors assessed for an association with survival included age, size of tumor, use of chemotherapy, presence of medullary involvement, presence of high-grade disease, local recurrence, and site of disease. Kaplan-Meier survival analysis and Cox proportional hazard regression were performed to calculate the survival rates and to assess for the effect of any factor on survival.
10-year overall survival rate was 77.1%, and 10-year event-free survival rate was 66.4%. No factor was found to have an association with overall or event-free survival.
These findings add to the available evidence which has failed to find any survival benefit from chemotherapy; patients with this rare disease and their families should be counselled regarding the unclear role of chemotherapy in this rare subtype of osteosarcoma.
骨膜骨肉瘤是一种罕见的起源于骨表面的变异型骨肉瘤，与传统骨肉瘤相比，其转移倾向较低，预后较好。目前缺乏支持辅助化疗能带来生存获益的文献。我们机构的做法是为高级别疾病患者提供化疗。
我们对1970年至2015年期间接受骨膜骨肉瘤治疗的患者进行了一项回顾性队列研究，分析生存结果，并评估生存与患者或治疗相关因素之间的关系。纳入了18例患者。研究人群的平均就诊年龄为20.8岁，平均随访时间为10.7年。评估与生存相关的因素包括年龄、肿瘤大小、化疗的使用、髓腔受累情况、高级别疾病的存在、局部复发和疾病部位。采用Kaplan-Meier生存分析和Cox比例风险回归来计算生存率，并评估任何因素对生存的影响。
10年总生存率为77.1%，10年无事件生存率为66.4%。未发现任何因素与总生存或无事件生存相关。
这些发现进一步补充了现有证据，即未能发现化疗有任何生存获益；对于这种罕见疾病的患者及其家属，应就化疗在这种罕见亚型骨肉瘤中作用不明确的情况进行咨询。
