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胸壁软组织肉瘤:更易导致更高死亡率和局部复发——一项单机构长期随访研究

Soft Tissue Sarcomas of the Thoracic Wall: More Prone to Higher Mortality, and Local Recurrence-A Single Institution Long-Term Follow-up Study.

作者信息

Soerensen Tine Rytter, Raedkjaer Mathias, Jørgensen Peter Holmberg, Hoejsgaard Anette, Safwat Akmal, Baad-Hansen Thomas

机构信息

Department of Orthopaedic Oncology, Aarhus University Hospital, Denmark.

Department of Cardiovascular Surgery, Aarhus University Hospital, Denmark.

出版信息

Int J Surg Oncol. 2019 Mar 4;2019:2350157. doi: 10.1155/2019/2350157. eCollection 2019.

Abstract

OBJECTIVES

This study aims to assess the impact of surgical margin and malignancy grade on overall survival (OS) and local recurrence free rate (LRFR) for soft tissue sarcomas (STS) of the thoracic wall.

METHODS

This retrospective cohort study identified 88 patients, diagnosed and treated surgically for a nonmetastatic STS located in the thoracic wall between 1995 and 2013, using the population based and validated Aarhus Sarcoma Registry and Danish Sarcoma Registry. The Kaplan-Meier method was used to estimate OS and LRFR. Multivariate Cox analyses were used to determine prognostic factors for OS and LRFR.

RESULTS

The 5-year OS was 55% (95% confidence interval (CI): 0.44-0.65) and 5-year LRFR was 77% (95% CI: 0.67-0.85). High malignancy grade and intralesional/marginal resection were identified as negative predictors for OS. High grade was the only prognostic factor associated with a lower LRFR.

CONCLUSIONS

In this large, single institution, study tumor grade was the key predictor for OS and LRFR. Surgical margin only statistically significantly influenced mortality, not local recurrence.

摘要

目的

本研究旨在评估手术切缘和恶性程度对胸壁软组织肉瘤(STS)总生存期(OS)和无局部复发生存率(LRFR)的影响。

方法

这项回顾性队列研究使用基于人群且经过验证的奥胡斯肉瘤登记处和丹麦肉瘤登记处,确定了1995年至2013年间88例因位于胸壁的非转移性STS而接受手术诊断和治疗的患者。采用Kaplan-Meier方法估计OS和LRFR。多变量Cox分析用于确定OS和LRFR的预后因素。

结果

5年总生存率为55%(95%置信区间(CI):0.44 - 0.65),5年无局部复发生存率为77%(95% CI:0.67 - 0.85)。高恶性程度和瘤内/边缘切除被确定为总生存期的负性预测因素。高分级是与较低无局部复发生存率相关的唯一预后因素。

结论

在这项大型单机构研究中,肿瘤分级是总生存期和无局部复发生存率的关键预测因素。手术切缘仅在统计学上对死亡率有显著影响,而对局部复发无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fac7/6425367/332c474154cd/IJSO2019-2350157.001.jpg

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