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胸壁软骨肉瘤:来自两个机构的 53 例回顾。

Chondrosarcoma of the Chest Wall: A Review of 53 Cases from Two Institutions.

机构信息

Department of Orthopedics, Klinikum rechts der Isar, Technical University, Munich, Germany.

Department of Orthopedics and Orthopedic Oncology, University of Padova, Padua, Italy.

出版信息

Anticancer Res. 2020 Mar;40(3):1519-1526. doi: 10.21873/anticanres.14097.

Abstract

BACKGROUND/AIM: Chondrosarcomas (CS) of the chest wall are rare, but present an aggressive biological behavior compared to CS of the extremities. The aims of the present study were to determine factors associated with oncological outcomes as well as complications.

PATIENTS AND METHODS

We retrospectively analyzed 53 patients (42 primary, 11 recurrent tumors). In total, 39 central CS, 10 peripheral CS, 3 dedifferentiated CS and 1 mesenchymal CS were included. The ribs were most commonly affected (68%). Overall survival and disease-free survival were estimated with Kaplan-Meier analyses and compared with log-rank test.

RESULTS

Mean follow-up was 7 years. Negative margins were achieved in 87% of patients. Thirty patients (57%) remained continuously disease-free (NED), three (5%) NED after treatment of relapse, seven (13%) were alive with disease, twelve (23%) were dead with disease and one of other cause. The 10-year survival rate was 81% and 45% in primary and recurrent tumors, respectively. Survival was significantly affected by tumor stage (p<0.001), local recurrence (p=0.025) and metastases (p=0.002). Six complications (16%) were observed.

CONCLUSION

The outcome is rather poor, especially in patients with local recurrence. Presumably due to a high biological aggressiveness, a stricter definition of surgical margins should be considered for this location.

摘要

背景/目的:胸壁软骨肉瘤(CS)较为罕见,但与四肢 CS 相比,其具有侵袭性的生物学行为。本研究旨在确定与肿瘤学结果及并发症相关的因素。

患者与方法

我们回顾性分析了 53 名患者(42 例原发性,11 例复发性肿瘤)。共有 39 例中央 CS、10 例周围 CS、3 例去分化 CS 和 1 例间叶 CS。肋骨最常受累(68%)。采用 Kaplan-Meier 分析法估计总生存率和无病生存率,并采用对数秩检验进行比较。

结果

平均随访时间为 7 年。87%的患者获得了阴性切缘。30 名患者(57%)持续无病(NED),3 名(5%)经复发治疗后 NED,7 名(13%)有疾病存活,12 名(23%)疾病死亡,1 名死于其他原因。10 年生存率分别为 81%和 45%,在原发性和复发性肿瘤中。生存显著受肿瘤分期(p<0.001)、局部复发(p=0.025)和转移(p=0.002)的影响。观察到 6 例并发症(16%)。

结论

结局较差,特别是局部复发的患者。由于其生物学侵袭性较高,因此对于该部位应考虑更严格的手术切缘定义。

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