Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).
Department of Orthopaedics, Zhejiang Quhua Hospital, Quzhou, Zhejiang, China (mainland).
Med Sci Monit. 2018 Dec 23;24:9370-9375. doi: 10.12659/MSM.911882.
BACKGROUND Elderly patients with Ewing sarcoma have a very poor prognosis, and treatment remains a challenge. However, the outcomes and potential prognostic factors of elderly Ewing sarcoma patients are rarely documented. Therefore, we investigated the prognosis of this special cohort and determine independent prognostic factors. MATERIAL AND METHODS A cohort of Ewing sarcoma patients aged over 40 years from 1973 to 2015 was identified from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan-Meier method and a Cox proportional hazard regression model were used for the prognostic analysis. RESULTS A total of 162 patients were included with a mean age of 53 years. The 5-year overall survival (OS) and cancer-specific survival (CSS) rates of the entire group were 43.7% and 47.9%, respectively. The sex, location, tumor size, and radiation treatment had no effect on survival outcomes on univariate analysis. Tumor stage, surgery, and chemotherapy were significant indicators of both OS and CSS on multivariable analysis. CONCLUSIONS Surgery in combination with chemotherapy had a significant survival benefit in elderly Ewing sarcoma patients and should be recommended.
老年尤文肉瘤患者的预后非常差，治疗仍然是一个挑战。然而，老年尤文肉瘤患者的结局和潜在的预后因素很少有文献记录。因此，我们研究了这一特殊人群的预后，并确定了独立的预后因素。
从美国国家癌症研究所的监测、流行病学和最终结果（SEER）数据库中确定了 1973 年至 2015 年间年龄超过 40 岁的尤文肉瘤患者队列。采用 Kaplan-Meier 方法和 Cox 比例风险回归模型进行预后分析。
共纳入 162 例患者，平均年龄为 53 岁。全组 5 年总生存率（OS）和癌症特异性生存率（CSS）分别为 43.7%和 47.9%。单因素分析显示，性别、部位、肿瘤大小和放疗对生存结局无影响。肿瘤分期、手术和化疗是多因素分析中 OS 和 CSS 的显著指标。
手术联合化疗对老年尤文肉瘤患者有显著的生存获益，应予以推荐。
